How Much can eHealth Affect the Economic Growth
-
Upload
plan-de-calidad-para-el-sns -
Category
Health & Medicine
-
view
1.777 -
download
1
description
Transcript of How Much can eHealth Affect the Economic Growth
Business Models for
eHealth: Results from an EU Project
Lorenzo Valeri (RAND Europe)
Patrick Jansen (Capgemini Consulting)
Daan Giesen (Capgemini Consulting)
Overview of the presentation
• eHealth: understanding business models for
going beyond financial issues
• Sizing the eHealth market
• Applying business models approaches to
eHealth
• Concluding remarks
e-healthcare business models: going
beyond financial issues
- Evolution of healthcare delivery-
• Financial sustainability
• eHealth systems for efficiency and
effectiveness of pre-existing
services
• Financial (and operational)
sustainability also via change
management
• Extended timings for the eHealth
system development
- Challenges for Business Modelling for eHealth
Socio-Economic
Trends
Health Specific Trends
Aging Funding complexities
Chronic Diseases Patients Mobility
Un-healthy behaviour Standardisation
Healthy and
independent lifestyle
Cultural differences
- Affecting Trends-
EU 27+2 – Total eHealth market 2008
& 2012
EU 27+2 – eHealth growth rates per
segment 2008-2012
Business models: Identifying the
interactions
Resources
PROFIT
CustomerOffer
Financial Performance
eHealth
Value
Proposition
Interactions
Change
management
Data collection
KEY
PARTNERS
KEY
ACTIVITIES
VALUE
PROPOSITION
RELATION PATIENT /
USER /
DOCTOR
SEGMENTS
CHANNELSKEY
RESOURCES
COST
STRUCTURE
REVENUE
STREAMS
What can partners do
to leverage your
business model (better,
at lower cost)?
What key activities do
you need to perform
and how easily can you
do this?
What key resources
does your business
model require?
Which of you clients’
problems do you solve
and which needs are
satisfied?
What kind of relations
does your
patient/user/doctor
expect and which kind
do you maintain?
Through which means
do your clients want to
be reached and which
means do you utilize?
What are your
patients’, users’,
doctors’ needs,
problems, desires, and
ambitions?
What is the cost structure of your business
model and is this in line with the core
values of the business model?
What value are your clients willing to pay
for and what is the preferred payment
mechanism?
Mapping eHealth Business Models
• Booking/cancellation/rescheduling and payment by patient of specialised visit or tests also via
pharmacies
• Integration with Umbria’s local radiology information system, laboratory information system and
hospital information system
• Direct link with Italy’s Ministry of Economic and Finance
• Multichannel access for patients to book/cancell/rescheduling of specialised test or visit
• Facilitation for rural areas
• Efficiency in the collection of payments for test (tickets)
• Financial incentives for the involvement of private pharmacies
• Client/Server solution via regional Intranet solution managed by Umbria’s in-house IT company
Webred
• Actors involved: 2 Regional Hospitals (Perugia/Terni), 4 local health authorities (Citta di Castello,
Perugia, Terni, Foligno) and 266 pharmacies (144 in rural areas, 122 in urban areas) and 487
specialist doctor or approved laboratories
• Potential users: over ca. 880.000 citizens, of which 140.000 foreigners (650.000 in the Province of
Perugia and 230.000 in the Province of Terni)
Solution
Environment
Main drivers to change Business Model
• Direct involvement of all actors in the development of the system
• Financial incentives for private pharmacies to link-up to the system
• Centralised IT infrastructure
• ITIL-aligned approach with IT support call centre (especially for private pharmacies) and for specific
operational issues (e.g. suspension of booking by a single laboratory/diagnostic centre due to long waiting
lists)
Key Success Factors Business Model
Centro Unico di Prenotazione-
Umbria
CUP: Changing the Business Model
CUP without pharmacies CUP with pharmacies
2 Regional
Hospitals
4 Local
Health
Authorities
Outpatient
Radiology
Departments
Outpatient
Laboratories
Hospital
Radiology/Laboratory
2 Regional
Hospitals
4 Local
Health
Authorities
Outpatient
Radiology
Departments
Outpatient
Laboratories
Hospital
Radiology/Laboratories
A144 Rural
Pharmacies
Citizen/Patient Citizen/Patient
1: Request of test/specialist by patient/citizens
2: Automatic check on availability and assign date/time for visit
3: Response back on availability/available time
4: Booking/rescheduling complete-Payment for visit by patients
A122 Urban
Pharmacies
Web-Red IT infrastructure Web-Red IT infrastructure
A15 GPs
4
1
3
2
3
1
2
4
CUP: Changing the Value Proposition
KEY
PARTNERS
KEY
ACTIVITIES
VALUE
PROPOSITION
CLIENT
RELATION
PATIENT /
USER /
DOCTOR
SEGMENTS
CHANNELS
KEY
RESOURCES
COST
STRUCTURE
REVENUE
STREAMS
Hospital wards
Diagnostic Tests
144 Rural Pharmacies
122 Urban Pharmacies
15 GPS
Web (TBD)
6 locations for
booking/payment/reschedule
/cancellation of
lab.test/specialised visit/ 281
locations
High quality service
Efficiency and
effectiveness
Multiple access points
especially for rural
areas
Customer
retention/additional
revenues for
pharmacies
Management of the
results of health
awareness campaigns.
Hospital structures
Local Healthcare
authorities
Pharmacies
GPs
Doctors
GPs
Patients
Pharmacies
Personnel
Direct cost (printing, etc…)
Education & Training for pharmacies
IT Call centre
IT system integration
IT support for pharmacies
Pharmacies:
2 EURO per booking
Better cash flow for pharmacies
Distant relation
Closer to needs of
patients
Diagnostic centres
Hospital/Local Health
Authorities
Patients
Pharmacies
Tactus: Serving Alcoholics online
• Tactus delivers care and treatment to addicts with alcohol, drugs, medicine, gambling, and eating
problems
• Especially alcoholic abuse has a stigma: people are ashamed; it is a taboo
• Tactus performs 5,500 units of care per year and the 2007 result was €1,605,000 (budget of €57
mio)
• 10% of all Alcoholics ever got help
• Research pointed out that preventive actions should indicate better results
• The behavioral change side of the treatment needs to be easily accessible
• Structured asynchronous Internet treatment program (Tactive) with a focus on cognitive
behavioral therapy through one-to-one counseling of a professional assistant:
• Two-sided treatment (diagnostics & behavioral change)
• Informative website
• Forum for online contact with fellow-sufferers
• Internet-based treatment (on a secured platform)
• Aftercare chat module
• Three executing organisations: Tactus, Mondriaan, and Symphora Group
Solution
Environment
Main drivers to change Business Model
• Research that underpins the benefits of the service, and gives opportunities to adjust
• Personal counseling relation between professional assistant and alcoholic is key
• Price from M&ICT of €650K
• No transportation needed, freedom in time and place
Key Success Factors Business Model
Tactus
Local, regional,
national
government
Healthcare
Insurer
Provide treatment &
care to clients
Professional
Assistants
Quality & Control; Subsidy
Knowledge
Orders & Leads; Money
Treatment
Feedback
Tactive
(Alchoholdebaas.nl)
Local, regional,
national
government
Healthcare
Insurer
Internet-based
treatment
Professional
Assistants
Tactus
ForumInformative
website
Aftercare chat
module
Source: Interview Hans Keizer, Tactive / Tactive Documentation
Tactive: Changing the Business Model
Alcoholic treatment before Alcoholic treatment after
KEY
PARTNERS
KEY
ACTIVITIES
VALUE
PROPOSITION
RELATION PATIENT /
USER /
DOCTOR
SEGMENTS
CHANNELSKEY
RESOURCES
COST
STRUCTURE
REVENUE
STREAMS
Local, regional and
national government
Tactus
TheFactor.e
Health insurer
Mondriaan
Symphora Group
Give care & treatment
Supervise assistants
Provide addict care
Develop internet-based
platform
680 Prof. assistants
20-25 Prof. assistants
Knowledge on diagnostics
& behavioral change
IT knowledge
Tactive online treatments
E.g. Alcoholdebaas.nl
Provide information,
fellow-sufferer contact,
treatment and aftercare
assistance
Roll-out to other areas:
Gambling
Drugs
Eating
Medicine
Need-oriented relationship
Personal & Anonymous
Patient has the control over
his/her own treatment
Front-end IT system
Professional assistants
Health insurer
People with addicts
Desired knowledge and
experience around
addictions
Other target groups:
Anonymous patients
Policyholders
Companies
Self-payers
Roll-out to other
countries
Personnel – Professional assistants
Education & Training
Coaching on digital treatment
IT application: development and
maintenance
Client fee: fixed fee + fee per hour for
delivered treatment/care
Franchise fee
Resell of application to other countries
Source: Interview Hans Keizer, Tactive / Tactive Documentation
Tactive: Changing the Value Proposition
Conclusions
• Mapping business model
• Long term commitment of senior management
• Not about new service but about news ways of delivering a specific
healthcare care specific service
• Financial commitment
• Stable financial support throughout project life line
• Final support for supporting staff commitment
• Patient’s needs
• Patients viewed as “clients” or “customers”
• Healthcare services aimed at providing more efficient services
• Open standards
• Explicit use of technical open standards to foster integration and follow-
up extension of functionalities
• Evaluation
• Senior management commitment to a-priori and ex-post evaluation of the
effects of IT-enhanced healthcare service
For more information
Prof. Jo Chataway
Director
RAND Europe
Westbrook Centre
Milton Road
CB4 1YG Cambridge
Tel:00441223353329
Email: [email protected]