Health Care in the Digital Age

Victor Dzau President, Institute of Medicine,

National Academy of Science

Patrick Soon-Shiong Chairman and CEO, NantWorks, LLC

Michael Milken Chairman, Milken Institute

Anna Barker Director, Transformative

Healthcare Networks, ASU

Atul Butte Director, Institute of Computational

Health Sciences, UCSF

John Chen Chairman and CEO,

BlackBerry

#MIGlobal

The principal forces shaping biomedical R&D

and healthcare delivery

Source: Complex Adaptive Systems, ASU.

Device-based

medicine

Information-based

healthcare

Molecular (precision)

medicine

Outcomes-based healthcare and sustainable health

New value propositions, new business models and services

• Remote health

monitoring

• Telemedicine

• m.health/e.health

• Data- and evidence-

based decisions and

Rx selection

• Molecular diagnostics

• Sensors

BIG DATA

• Panomics profiling

• Integrated analytics of

biological networks

#MIGlobal

ID of causal relationships between network perturbations and disease subtypes

Genomics

Patient-specific signals and signatures of disease or predisposition to disease and targeted Rx

Proteomics Molecular pathways and networks

Network regulatory mechanisms

Precision medicine: understanding molecular signaling

(information) pathways in health and disease

Source: Complex Adaptive Systems, ASU.

#MIGlobal

“Lab-On-Me” and “Lab-Always-On” dissolvable electronics

and biodegradable sensors

• Dissolution of electronic circuits in physiological conditions

• Construction from water-soluble, non-standard electronic materials with

specific dissolution rates

Source: Complex Adaptive Systems, ASU.

#MIGlobal

m.Health Real time remote

health monitoring

and chronic

disease

management

Lifestyle and

fitness

Information for

proactive health

awareness

(wellness)

Source: Complex Adaptive Systems, ASU.

#MIGlobal

23% increase in data breaches in healthcare

from 2013-20141.

Increasing Number Of Data Breaches In Healthcare

Sources: Symantec ISTR, Ponemon Institute Research Report.

#1 Healthcare data breaches accounted for

the largest % all data breaches in the

last 4 years1.

72% of healthcare organizations are not

confident or are only somewhat

confident in the security and privacy of

patient data shared on HIEs2.

FBI In 2014, the FBI warned the healthcare

industry that “the possibilities of

increased cyber intrusions is likely”.

#MIGlobal

$50K fine per HIPPA violation or up to $1.5M per calendar year per

identical violation.

The High Cost Of Data Breaches In Healthcare

Lawsuits and remediation costs can be more expensive than fines and

they are uncapped.

65% of recent hospital patients would avoid healthcare providers

that experience a data breach1.

+50% of recent hospital patients are willing to switch healthcare

providers if their current provider undergoes a data breach1.

Sources: TransUnion Healthcare Report, Fifth Annual Study on Medical Identity Theft.

$20B In 2014, medical identity theft cost consumers $20B in out-

of-pocket costs2.

100x The black market value of personal health records is $500 per

record, compared to $5 for personal credit card information.

#MIGlobal

Recent Data Breaches In Healthcare

Anthem, Feb 2015

$100M+ cost. 80M impacted.

Premera, Jan 2015

5 class action lawsuits, seeking unidentified damages. And Premara are now

offering all customers two years of free credit monitoring and identity theft protection

services, including identity theft insurance. 11M impacted.

Community Health Systems, Aug 2014

$75M-$100M cost. 5.4M impacted.

#MIGlobal

The Importance Of mHealth

Total spending on healthcare was 17% of GDP in 2012 and is expected to

increase to 22% of GDP by 2039.

It is estimated that there will be a 12.9M shortage of health-care workers

by 2035; today that figure stands at 7.2M1.

70% of treatment delays and sentinel events are due to communication

breakdown, in the healthcare architecture.

Source: World Health Organization.

#MIGlobal

Barriers To mHealth

DECENTRALIZED INFRASTRUCTURE: There are many systems for patient data and records and

every one of these needs a “special connector”.

TELEHEALTH POLICY IS NOT UBIQUITOUS: No two states approach telehealth in the same way.

REVERSE INCENTIVES: Private sector healthcare providers make more money if patients come to

the hospital more often.

‘COST’ OF MHEALTH DELIVERY: Who pays? The provider or the patient?

APPS: Lack of truly useful apps and efficient regulation of apps.

FEAR OF NEW PRACTICES / PROCESSES: Risk averse and time constrained industry.

#MIGlobal

56% say they lack budget to adopt mobile1.

Barriers To mHealth

41% say vendor immaturity is a barrier1.

95% say hospital IT is unwilling to support

smartphones on hospital networks due

to security risk. However, 98% are using

a personal smartphone to communicate

to patients and colleagues2.

100% are resistant to using a smartphone to

access patient information because of

limited screen size and data entry

capabilities2.

Sources: HIMMS Survey, Spyglass Survey.

#MIGlobal

BlackBerry In Healthcare

Secure mobile solutions across the continuum of care.

#MIGlobal

Segment

Category Acute Ambulatory Homecare

BlackBerry (Core Platform, VAS)

EMR/HIS/EHR

BlackBerry In Healthcare

Commercial Apps (Horizontals)

Strategic Partnerships

mHealth

Imaging

Secure

Communications

Medical Reference + Screening Instruments

Mobile App Management Mobile Office Communication & Collaboration Authentication & Access

Representative of BlackBerry

Healthcare portfolio as of Feb 2015

#MIGlobal Source: Atul Butte.

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“I want the country that eliminated polio and mapped the human genome to lead a new era of medicine  —  one that delivers the right treatment at the right time.”

-- President Obama State of the State 2015

President Obama Calls For Precision Medicine

“If Hell is where nothing connects, then being in the field of English must be the key to heaven’s door!

“We are in the business of finding connections – within texts, between texts and contexts, between texts and ourselves, between our readings and the readings of other interpreters.”

T.S. Eliot

“Hell is where nothing connects.”

T.S. Eliot

“Technology drives biology.”

- Anna Barker Co-Director

Complex Adaptive Systems Network, Arizona State University

2014 Partnering for Cures

The U.S. spends 90 cents of every health dollar

on treatment...

… and less than a dime on prevention and

research.

Abundant food and clean water

Defense against pandemics

Shield against bioterrorism

Reliable energy supplies

Environmental sustainability

Bioscience is more than health

Star Wars Video

Robohand Video

1975 $10

Cost of a 1-Minute Phone Call from the U.S. to India

Telecommunications cost to business approaches zero.

Today $.01

Download speed

In 2000: 1.2 megabits per second (Mbps)

Today: 300+ megabits

… and faster speeds are coming soon.

Source: PC World

Download speed

South Korea will invest $1.5 billion to upgrade

its mobile wireless networks for 5G speeds that

will be 1,000 times faster than what they have

today.

How fast is that? South Korea envisions the 5G

network being able to download entire movies

in a single second.

Source: PC World Sources: Los Angeles Times 1/23/14, South Korea's 5G network will shame LTE in the U.S.

IBM System 370/168 in 1976

8 megabytes for

$8 million

Cost per megabyte:

$1 million

Apple iPad Mini

64 gigabytes for $499

Cost per megabyte:

<$0.008

With access to the cloud, you get virtually unlimited storage at close to zero cost.

Today, there are more mobile phones –

8 billion – than people on the planet.

Source: Silicon India 2/28/13

Source: Juniper Research; Burrill & Company, Capturing Value

In 2012, there were 44 million healthcare app downloads.

In 2016, there will be an estimated 142 million healthcare app downloads.

Whatsapp Active Users (millions)

Source: WhatsApp

April 2013

800

600

400

August 2013

December 2013

April 2014

August 2014

January 2015

200

Duke University: 2015 National Champions

A Big Data Medical Research Lab?

Hospital Room of the Future