2016 Healthcare Trends

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real world scienceWere at the advent of a new age of clinical study, one that will dramatically amplify the size and scope of research. And, youre invited to join. trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

How much effort does it take to recruit participants for a medical study?

60,000We have sent out over 60,000 letters. Those 60,000 letters have netted 305 women.

- Kathryn Schmitz, PhD, University of Pennsylvania Health System

Really highlight the actual numbers from the quotes.

----- Meeting Notes (12/30/15 10:00) -----move the 10,000 people to the bottom. 3

How much effort does it take to recruit participants for a medical study?

To get 10,000 people enrolled in a medical study normally, it would take a year and 50 medical centers around the country.

Alan Yeung, Medical Director, Stanford Cardiovascular Health

50 med centers

12 months

10,000 people



50 med centers

12 months

10,000 people

Apple ResearchKit + Stanford University

0130,000



Welcome to the trial in your pocket.

How it works

Each day the app asks simple questions:How user feelsIf shes used an inhalerif shes taken her meds

Mount Sinai Asthma App

Uses phone sensors to track a multitude of data in the foreground and background

Integrates wearable data

Data is then sent to researchers on a dashboard

App is automatically tracking things like the GPS location so that it can match back other data, like pollen count, ozone, heat index, and other asthma-triggering conditions.

(Could present Sinai Steps in Similar Format as Digital Study, but ideally we have a screencast of the actual app)7

Review sites are the new targeted trials.

More than 30 million Americans take antidepressants, 30,000,000+4,041but the largest study conducted to-date included just 4,041 people.

Iodine is executing the first large-scale antidepressant study To add a review to Iodine, users start with comparable data by using numbers and buttons to share their topline experience.

*Can this be told in a screencast vs. text? 10

Each review is combined with others to let searchers see a snapshot of all user experience and then quickly toggle into specific subsets of users or view comments.

*Can this be told in a screencast vs. text? 11

And big brands are noticing the value.

*Brands with patientslikeme partnerships

The Final Frontier(For Now)?Electronic Health Records

The final frontier is EHRs.

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Guardant Health + Flatiron using big data and EHRs to help optimize clinical trials.

how much?The debate may be an old one, but its re-energized and raging in 2016. Patients, payers, and providers want to know: are these drugs really worth the cost?trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

Theres a war going on.

physicians are waging war. More than 100 prominent oncologists wrote in the journal Mayo Clinic Proceedings that they skyrocketing cost of cancer treatment puts sick Americans in an untenable situation as theyre fighting for their lives.

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VSDoctorsRising Drug Costs

Physicians are waging war. 17

VSDoctorsRising Drug Costs100 prominent oncologists wrote in the journal Mayo Clinic Proceedings that skyrocketing cost of cancer treatment puts sick Americans in an untenable situation.


VSDoctorsRising Drug Costs100 prominent oncologists wrote in the journal Mayo Clinic Proceedings that skyrocketing cost of cancer treatment puts sick Americans in an untenable situation. The American Medical Association recently voted to support banning DTC advertising to combat rising drug costs.


VSRising Drug CostsPatientsThe #1 health care priority for voters: Making sure that high-cost drugs for chronic conditions, such as HIV, Hepatitis, mental illness and cancer, are affordable to those who need them.


And here are their demands:

Advocates and physicians are asking for the following:

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And here are their demands:

new regulatory body

cheaperdrugimports

a forthcoming industry

costtransparencybills

Advocates and physicians are asking for the following:

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Back to the Black Hat?

74%72%72% of Americans feel that drug costs are unreasonable.

74% of Americans believe that drug companies put profits before people.

Screencast of scrolling through a Google News feed for Turning

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New Equations for ValueNational Comprehensive Cancer Network

efficacy +

safety +

quality of evidence

supporting therapy +

consistency of

that evidence +

affordabilityvalue oftreatment

There are also new equations to help patients make decisions and not just view drug costs in isolation..

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New Equations for ValueASCO

clinical benefits +

side effects of

treatment regimens +

patients out of

pocket costs

net health benefit score

There are also new equations to help patients make decisions and not just view drug costs in isolation..

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healthy getting healthierAlready motivated to live better? Good, weve got more stuff for you. But, what about the people who arent motivated yet? trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

The options for quantifying, encouraging, and tracking have never been greater.

The Wearables DreamPeople who need to become healthier will buy wearables, use them consistently, and be motivated by them.

The Current Reality: About half of wearable buyers are younger 35

One third earn more than $100,000

Only 10% wear them daily (PWC)

Over 50% Stop using them quickly (PWC)1/21/310%50%

Healthcare app data.

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So whats driving real behavior change with those that arent as inclined to be healthy?

So whats driving real behavior change?34

In previous years we tried TELLING people what to do.

So whats driving real behavior change?35

The National School Lunch ProgramThe Result?


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$1.2 Billion Annually50%Of Served Fruit75%Of Served Vegetables25%Of Served Milk


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So in 2016

were helping people DISCOVER what to do.

So whats driving real behavior change?

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Contextual Clues vs Restriction

Google cafeteria insights:

Plate sizeHealthy StickersRelegating sweet beverages to the bottom and nutritious foods at the front.

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Incentives

wellcoin40

Elevating wearables as medical devices

Focusing on wearables that can be classified as medical devices. Noom + CityMD Samsung S Health Diabetes Program41

any doctor will do In 2016, healthcare is happening everywhere. Consumers are finding trusted health professionals in pods, on iPads, in stores, on the couch, and more. trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

Telehealth and other alternatives are sweeping the nation

9%20%13%45%??Sought care usinga telehealth serviceSought care at a retail health clinicSought care at an urgent care clinicOf telehealth users were unaware of these services 2-3 years ago

In the US, 64% would try new, non-traditional ways of seeking medical attention and treatment if the price was right64%And the globe.

And the globe. In Canada, 52%of patients predict that mobile health (mHealth) will improve the convenience and access of healthcare52%

And the globe. In Germany, 43% are willing to accept services and products from non-traditional healthcare providers43%

And the globe. In emerging markets, 54% expect that mHealth will improve the quality of healthcare they receive in the next three years54%

Home health is becoming personalized.

Cell scope,

Maven,

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Designed for:

children with reoccurring ear infections

$79 device that attaches to iPhone camera.

Footage is sent to on call doctors who can prescribe care within two hours. 49

Designed for:

womens healthcare

Schedule time with a doctor, connect via video, and collect notes from exams.

50

Designed for:

caregivers working with elderly or frail patients

Contains bluetooth diagnostic tools. 51

And this means BIG savingsUsing digital health tools in primary care could save the US healthcare system $10 billion annually Accenture

And BIG impact for the healthcare system Accenture, 2015PATIENT OFFICE VISITTIME SAVINGS 37,000 PCPs(18% OF PCP WORKFORCE) ANNUAL VALUE ~$7 BILLION

Dont want to stay at home? Grab and go healthcare at the store. Nurse Practitioners for proactive health screenings and active chronic disease management

Partnerships with hospital operators for in retail clinics

Health Kiosks for vital signs and basic health measurements.

HD Telehealth Video Conferencing

Gaming dynamics to customers

Today share of the 10 billion immunization market is 4%, with room to grow

(*Can we create icons for each of these menu items?)

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prescribed prescriptionsPayers, administrators, and patients are ripping away decision making from the point of care. trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

What well pay forWhat we can affordWhat weve seen work

Consolidation is leading to new influence

LIVES COVERED BY EXPRESS SCRIPTS:2005201512 MILLION 85 MILLION

And that influence is increasing thanks to consolidation. If you think about any other aspect of health care, no one has accumulated 85 million lives that they can represent Steve Miller

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Their reach is being found directly within the workflow

29% of physicians report that their EHR automatically restricts prescribing choices due to formulary guidelines.

29%

fee-for-service reimbursement fee-for-service reimbursement

outcomes-based compensation plans

Health Systems are shifting their payment models FROMTO

ACOs Preferred Practice Formularies. 59

Increasing reliance on the Director of Pharmacy role

to set the treatment policies that guide physician practices throughout the system.

60

Decreased choice, but decreased hassle55% of physicians agree that participation in ACOs will constrain the level of choice they have when it comes to what they can prescribe for patients

Manhattan Research, 201555%

ACOs Preferred Practice Formularies. 61

Patients are being sticker-shocked into action38%52%38% of men said they opted out of going to the doctor to save money. 52% of women shared the same sentiment. eHealth survey, 2015

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Tools employers are providing to boost consumer-like behaviorSelf-service decision supporttoolsPrice transparency tools for medical servicesMedical decisionsupport & secondopinion servicesEmployee advocacy tools & services for claims assistanceHigh-touch health concierge servicesPatients are encouraged to behave like consumers

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Consumerist Patients

Users enter healthcare service they need.

Smartshopper finds the prices at high quality local providers.

Consumer shares in savings.

64

teamhealthConsolidation and specialization have created deep benches of professional talent at many practices. For patients, that means a new player, a new face at every visit. trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

In 2015 healthcare was in a merger frenzy.

Can we have these logos coming together and then turning into just the one on the left? 66

In 2015 healthcare was in a merger frenzy.

Can we have these logos coming together and then turning into just the one on the left? 67

In 2016, the buying binge will refocus on the site of care.

Independent small and midsized practices joining up with management companies, hospitals and integrated delivery systems.

Due to structural shifts in NA and euro health care systems AND generational shifts in physicians attitudes toward work-life balance as seen in this chart.

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In 2016, the buying binge will refocus on the site of care.



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Encouraged by evolving physician attitudes46%33%23%21%Top physician reasons for consolidation Gain/retain income security Leverage negotiating power with payers Achieve/retain work-life balance taking advantage of organizational infrastructure Deloitte survey of US physicians



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GroupMed

13

The average cancer patient sees more than 13 different health care providers in a 12 month period.

More than 46% of these patients see more than 21 unique health care providers. -Biologics benchmark study

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Hot jobsPHYSICIAN ASSISTANT U.S Bureau of Labor Statistics projects number of PA jobs will increase by 39% from 74,800 in 2008 to 103,900 in 2018NURSE PRACTITIONERThe number of NP licensed in the U.S has nearly doubled over the last ten years. - AABP, 2015PATIENT NAVIGATORPatient Navigators listed #11 on list of top 13 jobs for the next decade. - KiplingerHEALTHCARE

IM CARING FOR YOU IM CARING FOR YOU HOURS WORKED HOURS WORKED OWNING MY PRACTICEOWNING MY PRACTICE

WERE CARING FOR YOUIMPACT MADEMULTIPLE EMPLOYERSFROMTO

Millennial Doctors are thriving in the shifting healthcare environment.

52% dont want to own their own practice

Want to be a part of teams, outcome based to reach finanical goals, leverage tech.

73

first visit, second opinionPatients are coming into the practice with strong opinions about whats wrong and what they need to feel better. trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

The evolution of the empowered patient

Patients became actively involved in their care.

88% feel confident in their abilities to take responsibility for their health 89% agree that they know where to look and whom to ask if they have health questions or concerns

64% feel that they could be making more decisions about their health and wellness

This inconvenient informed patient became theexpected patient.

1:5 patients said that doctors are more likely to ask them to make a final decision about treatment compared to two years ago.

Patients are becoming empowered to say no to end of life care.

Whats next?

Patients interpreting data and providing themselves with direction.

Personal Analytics Dashboards

Patients interpreting data and providing themselves with direction.

Wearables as a coach

caregivercrunchMillions of people are doing a job they were never trained for: managing the health and wellness of an aging loved one. trend 01trend 02trend 03trend 04trend 05trend 06trend 07trend 08

Who are our caregivers?

1:10 people in the UK are caregivers 1:6 people in the US are caregivers 1:4 people in Canada are caregivers

the number of family caregivers available for each person requiring care is projected to drop from 7 to 3. Thats the number of available caregivers not the number who will actually agree to help.

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Who are our caregivers?

49 years old60% are femalefull-time job

24 hours a week caregiving


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Were approaching a caregiver cliff.

The number of family caregivers available for each person requiring care is projected to drop from 7 to 3


**Can we do an animation with the 7 number dropping to 3?

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They need support Around 9 in 10 want more opportunities to meet and share knowledge and experiences with.

More than 8 out of 10 caregivers say that they could use more information or help on caregiving topics.


professional carers (93%) as well as with other family members and informalcarers (90%)86

And they are getting olderOlder adults caring for spouses provide an average of nearly 45 hours-a-week of care, nearly twice the average.

Caregivers who are 75 or older are less likely to have paid help, are managing their family finances, and act as medical advocates.

To help meet their needs,2016 will bring new ideas in:

support systems

employment law

financial incentives


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Healthful Caregiving?

non-caregivers had significantly higher mortality rates over a 6-year study than caregivers

which the principle investigator called a considerable survival advantage.89

special thanksAbigail SchmelzerAlex BrockAllison PignatelliAmanda JolyAmardeep LallyAndreas ReinbolzAndrew GlennAnn ManousosBrooke GlanzbergChris DevineChris IafollaChristina BlosserChristopher CallahanDan SmithDave SondermanDuncan ArbourEd HammertonEduardo MenendezElizabeth StelzerEric DavisEric SaboFrancine CarrickHeather IrvineIlya TetelmanJames TomasinoJason SankeyJeffrey GiermekJennifer FleishmanJennifer OleskiJessie BrownJoanna VoorhisJoe DesalvoJohn MuchaJoy HartJuli CavnarKara KinseyKevin ColemanKevin NaltyKristianne ShankerLeigh HouseholderLiana FedericoLogan CooperMaggie JancoMarci PiaseckiMark JazvacMark StechschulteMatt MizerMatthew BergenMelissa MorrowMichael BonillaMichelle CasciolaNaseem AllafNate LemkeNicholas CapanearNick BartlettNicole SordellNina BressauPat EtterPatrick RichardsRupert DooleySalvatore CannizzaroSarah BrownScott PageStephanie JonesSusan PerlbachsTom CallanTom MullinsTyler SaxVaneeta VermaVanessa RiveraZach Gerber

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2016 Healthcare Trends

Healthcare

Transcript of 2016 Healthcare Trends