deep innovation

Connected Life: the global future

Dr. Thomas Wilckens, deep innovation GmbH Euroforum, November, 2012

The convergence of mobile with ICT: Disrupting the biopharmaceutical industry

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Disruptive Innovations in Pharma: Gamechangers of previous business models

Industrialisation of drug development during WWII

New R&D technologies New therapeutic principles New alliances

New competition New marketing strategies New alliances

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mhealth: a global trend and/or necessity?!

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mhealth refers to the use of mobile communication and devices for providing healthcare services or achieving health outcomes mHealth comprises wellness, fitness and medical services (prevention & treatment)

Olympians trade data for tracking devices

July 26th, 2102

WHO/UN constitute the requirement for intelligent, mobile health care support systems to appropriately address the world increasing health care challenges UN Resolution A/66/L.1 16th, September 2011 on NCDs

deep innovation Connected life by 2020: Creating opportunities by cross-industry operations

deep innovation Mobile ICT Technologies: Gamechanger and Enablers mobile technologies induce disruptive innovation

LTE/4G Networks: Ubiquitous & 5x faster than UMTS

Attributes of the world population: • only 70% access to clean water • 90% lack access to medical treatment • 90% accessible via mobile technologies

MD mobile/wireless adoption (USA)

Tablets

Smartphones

deep innovation Decentralization versus Centralization: mobile computing as disruptive innovation

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Centralised IT-technologies only for few solvent clients

Ubiquitious access disrupted exitisting business models, industries and society

deep innovation Decentralisation in diagnostics & therapeuticals: mobile computing, cloud technologies and POC drive disruption

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The disruption off healthcare by mobile, wireless ICT is just at the beginning

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mobile ICT will disrupt existing business concepts IBM‘s transition in the 90ties as a role model for Pharma?

Pharma’s future business model?: • Drug development & marketing

mobiIe ICT enabled opportunities : • Improving efficacy in R&D • Disease management including QM • Disease prevention and health management • Value added services (VAS)

IBM‘s change from a pure IT company to services and high tech innovation: • driven by technological disruption • PC = smaler, cheaper, eabling access to new clients • New players, new competition, new business concepts

How will the health care market look like in the future? Who will reign the world of health care in 2030?

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communicable versus non-communicable diseases

Exponential population growth

Lack of infrastruture and organised health care systems

Lack of MDs (worldwide 200k WHO, 2011)

90% access to mobile

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The world‘s health care crisis

Increase requirement for prevention & treatment

Exponential growth of costs

Continued lack of access; increased disease burden

Thread of increased gap in access to health care between economies

Opportunities for mhealth technologies

Framework: Consequences:

deep innovation The route to precision medicine: mobile ICT & Big Data (new) as gamechangers

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Symptom-based

(Trial & Error)

Rules-based

Pattern-based

Intuition Medicine

Precision (Personalized)

Medicine

Evidence-based

Medicine

Yesterday & emerging markets Today

Tomorrow

With the advent of mobile ICT enabled solutions, emerging markets will leapfrog western world today‘s medicine and create new business models

Available data sets

Action

*omics

mobile ICT Big-data

deep innovation

Dada Mining, Expert System, Therapy, Context

matching

Data management, Personal health records

Monitoring, Analytics, distributed, secure data

storage and „HealthSecurity“

Mobile und portable vital data measurement,

Preprocessig and control

CASE-specific: User interface, Data representation, Alarm,

Parameters

Data transport, near field communication, mobil and fix

Non invarsive Sensoric

Lab on a chip Technologies

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The mobile diagnostics/monitoring technology & value map Structure, competences, plattforms, up-scaling & value added services (VAS)

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User- and administration interface Value added services (VAS) and APPs

Central platform functionalities with general application features; i.e.: • Secure data collection, storage, managment and

extraction/analysis • Monitoring and alarm • Personalised health records • Expertsystems for datamining, epidemiologic analysis,

therapeutic decisions etc. • Datatransmission via operator

Target case specific diagnostics/sensor and actuator at the frontend • Single point measurment • Repeated measurement (chronic monitoring) • Continuous measurement and monitoring

Standard Integration Core Tech Partners UseCase spec. Frontend tech

Non invasive sensors

VAS create a new and sustainable business opportunity for early adopters

deep innovation mICT driven disruption enables access to health care: Convergence of technologies, i.e. innovation creates business opportunites

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Lab-on-paper (LOP)

Novartis/Proteus‘ compliance management: • New alliances form new business models • Innovation requires new alliances

Harvards‘ cheap POC diagnostics: • Diagnostics are an essential prerequisite for

appropriate treatment Caveat: • Where does the diagnosis come from?

Who will advice the treatment?

New POC/companion diagnostics will only create value in combination with mobile ICT and intelligent data management & value added services (VAS)!

Intelligent pill & compliance: eatable microelectronics

deep innovation Use case, mobile point-of-care diagnostics (mPOC): Reducing costs and enabling new clinical trial strategies & theranostics:

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Secure data management

Data collection and secure transmission

Data reporting end remote

entree

Administration, Control, Monitoring, Exception Handling

Increasing challenges: Costs per drug trial 400 -1200k€ Increased number of patients required Extended trial durating

Selected advantages of mLOC • Reduced monitoring costs • Enabling new recruitment • Enabling remote patient enrolement

Potential for cost reduction 20-50% per trial

Proof of concept: Pfizer established FDA-approved first virtual mobile trial POC

Mobilized analytics instead of repeated trial center visits

Advantage of Pharmapartnering: non-regulated market with pressing innovation need

deep innovation Impact of mobile ICT on Pharma‘s business model: remote, real-time 24/7 access to patients and data

Who pays, when, what,

why?

deep innovation Showcase diabetes management as an example: Integrated service concepts: Drug, device, services

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Wireless, needle-free, continuous glucose monitoring

Implantable sensors

Wireless controlled insulin pump

Who will pay for costly high end products in „old“ regulated markets? Are these concepts suitable for globalisation/glocalisation?

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Indian Researchers To Develop Affordable Diabetes Test Strips; 09 Nov 2011 Health Minister : "Diabetes is highly prevalent in the country and the strip to measure sugar level is imported as it is patented abroad and it costs Rs 30." (ca. 42ct)“. Turkey (10,7million patients, reembursement reform 3/2012): Support for meters in : 20TL = 9€; Support per strip: 0,32 TL = 14ct

Diabetes Management, what‘s next? High end solutions for established markets & emerging markets?

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Solutions for emerging markets? Novartis/IBM challenge winner: Dr. Diabetes for China - ESADE Business School-Universidad Ramon Llull

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3 examples for Reverse Innovation: Innovative products will also disrupt „old“ health care markets

Lab on paper

Local Projectstart 2000 Market Entree 2006

US Market Entree 2010

Egypt Market Entree 2008

Project Start 2006

EU Market Entree 2012

1 GE‘s mobile Ultrasound

2 Harvard‘s Lab-on-paper

3 ePayment

1 developed and 1st marketed in China

2 developed in USA, POC ongoing in Africa

3 developed in the EU, introduced 1st in Africa

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Optimized disease management in emerging and „old“markets; i.e. efficient and affordable:

Selected objectives (starting from scatch appying Reverse Innovation principles):

mobile ICT & POC: enabling access to health care Generate problem-oriented solutions within a contextual framework

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1. Market-specifically tailored diagnostic devices (test-strips, mReaders, sensors….)

2. Integrated algorithm-based dosing management (cloud-based and/or Smart Phone)

3. High end versus low end versions for regional markets and/or client groups

4. Remote/mobile QM and disease management services in a cultural context

5. Low energie, ecologically neutral

6. Culturally adjusted value-added-services (VAS)

7. Identify general principles applicable from fever diagnostics to chronic condition management

8. Adjust for (re-) introduction into „old“ markets

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optimized exploitation of Pharma‘s core competencies & ressources

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Munich Network 19

mobile ICT technologies disrupt existing business New opportunities for innovative technologies and value added services

Prevention, Early diagnostis, Monitoring

Personalized Medicine, Theranostics

Point of Care Diagnostics

New products and services

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Present Future

deep innovation Anticipating the convergence of all aspect of life mobile computing, sensors, diagnostics, health/fitness/wellness apps

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Mobile computing

Connected diagnostics/monitoring

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The best way to predict the future is to invent it! Vinod Khosla, Founder of Sun Microsystems, Serial Entrepreur & Health Care Investor

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Intelligent pill; eatable microelectronics

Mobile ICT Technologies: Gamechanger in Medicine mHealth examples and anticipated products

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Intracutane nanoparticles Calcium-Glucose

Litium, Biohazard

LOP Livertox-test

Air pollution

Bloodcellanalysis

Lab-on-paper (LOP)

deep innovation Deficit compensation: Anticipating the next level of remote controlled sensors & devices

Implantable MEMS

Epidermal electronics

Intelligent sensor & augmented realitly

after partially detach from the skin

Bantenna LED

wireless power coil RF coil

temp. sensorstrain gauge

RF diode ECG/EMG sensor

0.5mm

after fully detach from the skin

attachedto skin

detachedfrom skin

silicone

crumpled circuit

5mm

3mm

silicone(~50 kPa)

PI

PIdevice

NMP

30µm

7µm

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Systems inefficiency as percent of total economic value by system Big data drive excellence and efficacy

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Potential for improvement in health care app. 2 Trillionen US$ Source IBM

Economic efficiency from data acquisition, storage, extraction and analysis Optimal field for innovative services and novel business models based on

Mobile & wireless ICT

18%

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Department of Homeland Security's National Cybersecurit (USA, 16.05.2012):

„Medical devices and smartphones can expose patient data and also lead to cyber-security problems, the Department of Homeland Security warned.”

• The health care industry's adoption of mobile technology poses certain security risks to health data,

according to a report by the Department of Homeland Security, Government Computer News reports (McCaney, Government Computer News, 5/16).

• DHS' National Cybersecurity and Communications Integration Center issued the report, titled, "Attack Surface: Healthcare and Public Health Sector" (Horowitz, eWeek, 5/16).

About the Security Risks: • The report stated, "Since wireless medical devices are now connected to medical IT networks, IT networks are

now remotely accessible through the medical device.“ It added that "communications security of medical devices to protect against theft of medical information and malicious intrusion is now becoming a major concern" (Kurtz, Becker's Hospital Review, 5/17). Read more: http://www.ihealthbeat.org/articles/2012/5/18/dhs-mobile-technology-poses-security-risks-to-health-data.aspx#ixzz1vUKg1pc9

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The callenge: Data safety and security; see also ICT Summit 2012, Dec. 6th Munich 2011

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Critical health risks and cost drivers: • Transition from ICU to general unit:

Wireless Sensors Relay Medical Insight to Patients and Edwards, J. Signal Processing Magazine, IEEE Volume: 29 , Issue: 3 Digital Object Identifier: 10.1109/MSP.2012.2183489 Publication Year: 2012 , Page(s): 8 - 12

• Transition from the clinic to home: Strategies To Cut Costs Integrated Telehealth And Care Management Program For Medicare Beneficiaries With Chronic Disease Linked To Savings; doi:10.1377/hlthaff.2011.0216 Health Aff September 2011 30:1689-1697;

Integrated mHealth solutions have proven to reduce readmission to both, ICU or hospital Seemless data management between health care providers further contributes to improved and cost effective patient management and secures improved quality services Caveat: Succesful technical implementation requires converging competencies ranging from datatransfer over device energy management to safety/security solutions combined with user friedly value added servides (VAS).

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Use case, improving health care efficacy: Seemless monitoring & Point of Care diagnostics