Project I Virtual Doctor-final

Engineering Leadership Professional Program

Virtual Doctor’s Office Authors: Samantha Ranaweera, Suchitha Che1a, Amit Joshi, Vijay Tala1, Purnima Varma, Sukh Lobana March 23rd 2015

This work was created in an open classroom environment as part of the Engineering Leadership Professional Program (ELPP) developed and led by Prof. Ikhlaq Sidhu at UC Berkeley. There should be no proprietary informaLon contained in this work. No informaLon contained in this work is intended to affect or influence public relaLons with any firm affiliated with any of the authors. The views represented are those of the authors alone.


“The Affordable Care Act is crea3ng a huge opportunity, We’re realizing that the majority of people’s appointments with doctors are for things that could be done online. We see telemedicine and online mental health services going mainstream in coming years.” John Sculley former President & CEO of Pepsi-‐Cola & Apple, Inc. "Facial expression, body language and reac3ons to different ques3ons or subject maHers are all available for an aHen3ve virtual therapist." Dr Phil’s Doctor-‐On-‐Demand, backed by Richard Branson & Google Ventures.


Telemedicine - Existing Market and Growth Trends

Market Analysis Telemedicine is 11.4% of overall mkt (280M$) Telemedicine in North America projected to grow at a compound annual growth rate of 16.7 percent from 2012 to reach more than $600 million in 2017”. Consumers showing increased interest and enthusiasm for using mobile devices to engage with healthcare providers. Overall Remote PaLent Monitoring (RPM) market expected to grow at an annual growth rate of 35% between 2013 and 2018, reach $26.5 billion by 2018. (eWeek Report)

5.80 7.83 10.57

14.27 19.26

26.01

0.00

10.00

20.00

30.00

Remote Pa1ent Monitoring

CY2013 CY2014 CY2015 CY2016 CY2017 CY2018

$ (In

Billions)


Telemedicine – Current Landscape Early movers trying to capitalize on the projected demand. CreaLng a niche and/or low cost alternaLve to insurance backed medical examinaLons/consultaLons. Keen interest amongst employers to reduce their OPEX costs. NaLonal insurers pitching tele-‐health & telemedicine to consumers.


Telemedicine - Stakeholder Segments Func1ons Ac1vi1es Consumers

Consumer/Family Wellness and PrevenLon

•  Measure weight, exercise and calories consumed •  Minor ailments, measure vitals for triage

•  Consumer/family •  Caregiver (adult child or parent) •  Employer/plan sponsor

Chronic Disease Management

•  Diabetes: monitor blood glucose •  CHF: track weight, General: medica1on adherence •  Hypertension: track blood pressure •  COPD: measure strength of breath

•  Health Plan •  Employer/plan sponsor •  Provider (pay-‐for-‐performance or bundled-‐

for-‐ condiLon)

Acute Care, Post Acute & RehabilitaLon

•  Prevent hospital readmission •  Monitor physical therapy at home

•  Medicare, under Accountable Care Act •  Health Plan •  Employer/plan sponsor

Aging at Home

•  MedicaLon opLmizaLon •  Remote monitoring of vital signs and ac1vi1es of daily

living, AssisLve technologies (e.g., smart home, smart wheelchair)

•  Health Plan •  Consumer/family

Rural PopulaLon •  Prevent distant travel under trying circumstances –

Tremendous market in developing world •  Rural Consumer/family •  Military deployments •  Out posts (AntarcLc/ArcLc)

InfecLous Disease Management

•  Manage isolated highly infecLous paLence •  CDC


Current Players: Wellness and Prevention 1.74B$

430M$

280M$


Premium Breaks $↑/$↓???

$40-‐$49

Spot Light – MDLIVE (Revenue Model)

$40-‐$49 (Standard)

$30-‐$37

$20-‐$38 (Thru Employer)

100$

49$

38$

Lower cost of ownership

Lower cost of service Convenience

Reduced healthcare costs Reduce absenteeism Improved producLvity Increased profits

Increase consumer opLons

Increase consumer opLons

Doctor/Physician/ Psychiatrist

FoundaLons/ Insurers

Individuals/ PaLents


Opportunity

/

Body Temp

Pulse/Blood pressure/Stethoscope

Ear/Throat camera

Pulse Ox

Seamless CommunicaLon channel •  Audio-‐Video •  Integrated Help menu, Nurse,

Dr guidance

Integrated With Health care providers and Insurance Companies backend •  Savings for both Consumer and

Insurance Companies – Win-‐Win! •  Health care providers can focus on

acute cases Vs trivial condiLons

Integrated Sensor kit •  FDA approved for home/OTC usage -‐ No one has it! •  Combined Stethoscope, thermometer presssure meter, ear scope,

Pulse Ox meter – No one has it! •  Idiot proof J -‐ Simple to use! •  Bluetooth, wired connecLon to Phone/Laptop, controlled by App •  Low cost – Less than 100$ •  Portable

Triage Resolve


Feature Target CellScope ZyphyrLife Preven1ce UPMC AnywhereCare MDLIVE DrOnDemand

OTC/Home usage ü ü û û û ü ü

Triage pa1ents ü ü (Ear only) û û ü ü ü Integrated Sensors

Body Temperature ü û û û û û û

ECG ü û ü ü û û û

Respirator Rate ü û ü ü û û û

Stethoscope ü û û û û û û

Blood Pressure ü û û û û û û

Pulse OX ü û û û û û û Otoscope (Ear/Throat Cam)

ü ü(Ear only) û û û û û

Accelerometer ü û ü ü û û û

Bluetooth ü û ü ü û û û

Integrated App with HSP ü ü ü ü ü ü ü

Integrated App with Insurance ü ü û û ü ü ü

Integrated Help ü ü ü û ü ü ü

Why will we win – We Create a new market


Backup

Backup


Barriers To AdopLon Of Telemedicine

Regulatory Challenges Insurances

Physicians Workflow Challenges

Hospital Ambivalence

PaLent/Consumer Engagement


Technology: The Ecosystem

Source : The Connected PaLent , By Jane Sarasohn-‐Khan, Prepared for California Healthcare FoundaLon


Technology -‐ Sensors & Wearables •  Sensors and wearable's allow conLnuous physiological monitoring with reduced manual

intervenLon and at low cost.

Ref

Collect Health Data Transmit Evaluate No1fy Intervene

Ref


Mobile Doctors Office – Business model canvas Problem Inability to triage health condiLons without visiLng a doctors office/ER/Urgent Care

Solu1on Mobile app that connects paLents with Health Care Providers (HCP) using video conferencing, supplemented with hardware, to take all vital-‐signs( temperature, pressure, heart / respiratory rate, stethoscope capabiliLes, look inside ear, throat, Pulse-‐Ox), all for less than 100$.

Unique Value Proposi1on •  AnyLme,

Anywhere •  Instant

soluLons for trivial issues

•  Instant IntegraLon with HCP backend data base

•  Savings to both paLent and HCP

Unfair Advantage •  Market Creator

(no exisLng comprehensive soluLon)

Customer Segments •  General

PopulaLon •  Chronic paLents

requiring constant monitoring

•  HCPs •  Product

DifferenLaLon -‐ Holographic remote presence

•  Emergency Response Management

Key Metrics •  App sales/downloads •  Supported instruments •  Integrated HCPs •  HW unit sales

Channels •  Peripheral HW

providers •  HCPs •  FDMs

Cost Structure •  App development, Web hosLng, Support Center •  Peripheral HW development/integraLon (Thermometer,

stethoscope, Otoscopic extender, Pulse Oximeter) •  Regulatory compliance •  HCP integraLon

Revenue Streams •  Free App to paid version conversions •  Peripheral HW sales •  HCP licensing •  HCP rouLng preferenLal fees when paLent does not know

who to call •  Insurance company purchases for covered paLents


References Growth and Innova1on in the Health Care Industry – Trends, Opportuni1es, and Challenges – By Frost & Sullivan hup://www.frosvtp.com/dev/2014/FA/UnitedHealth_HC_Trends_Discussion.pdf The Baby Boomers’ Massive Impact on Health Care – By Chris3na Orlovsky, senior writer hup://www.nursezone.com/nursing-‐news-‐events/more-‐news/The-‐Baby-‐Boomers%E2%80%99-‐Massive-‐Impact-‐on-‐Health-‐Care_28946.aspx Wireless-‐Enabled Remote Pa1ent Monitoring Solu1ons – By Rajeev D. Rajan, Senior Director of Product Management, Qualcomm Life hup://www.mdtmag.com/arLcles/2013/05/wireless-‐enabled-‐remote-‐paLent-‐monitoring-‐soluLons The Connected Pa1ent: Char1ng the Vital Signs of Remote Health Monitoring Prepared for – California HealthCare FoundaLon By – Jane Sarasohn-‐Kahn hup://www.chcf.org/publicaLons/2011/02/the-‐connected-‐paLent ZyphyrLife -‐ hap://zephyranywhere.com/healthcare/zephyrlife-‐home/ Preven1ce -‐ hap://www.preven1ce.com/products/the-‐preven1ce-‐care-‐pladorm/ BioSign -‐ hap://www.biosign.com/ Doctor On Demand -‐ hap://www.doctorondemand.com/ MDLive -‐ haps://www.mdlive.com/

Project I Virtual Doctor-final

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