Transformational Shift: New Business Models in Healthcare

 

    PRESENTER
    Greg Caressi
    Senior Vice President,
    Transformational Health
    Frost & Sullivan

 

SESSION ABSTRACT
This discussion helped participants gain valuable insight into new marketplaces and implications across value chains. Examples of how transformation in healthcare can be leveraged to develop new business models were also presented. Participants examined top global case studies and utilized them to identify new channel partners, new customers, new convergence ideas and revenue streams across the entire ecosystem.

KEY TAKE-AWAYS:

• An assessment of the future success potential of current and emerging business models in the B2B and B2C segments across industries
• Identification of new partner networks, future customer segments and valuable revenue streams for your company
• Analysis of new product positioning, new value proposition through creation of a business model canvas

OVERVIEW

Healthcare is being transformed and new business models are evolving around six overall themes:

1. Building an Ecosystem
2. Moving from Product to Service
3. Decision Support
4. Integration Is King
5. Process Change
6. Mass Customization

Some key developments in new healthcare business models include:

• Artificial Intelligence solutions being used for workflow optimization (e.g., triage) purposes
• The use of social media, more on the consumer side than the institutional side, for purposes such as activity coaching
• The tendency to view market segmentation and/or fragmentation as an opportunity where one solution can be adapted across various stakeholders
• Enhanced patient comfort level with having their information reside in the cloud
• Consumer willingness to co-pay seems set at around $30-$50
• Genomics is one new area of innovation in business models; within 5 years it willbe considered ―malpractice not to use some genomics technologies, particularlyin oncology
• Intermountain Healthcare is one of the leaders in offering healthcare providers genomics testing
• IBM Watson is partnering with Memorial Sloan Kettering to leverage genomics and analytics
• The American Society of Clinical Oncology (ASCO) is partnering with Systems, Applications and Processes in Data Processing (SAP) to develop big data solution for oncologists nationwide
• Shared infrastructure platforms are being shared across practice groups

TAKE-AWAY

• 64% of patients would see a doctor via video
• Access and convenience is more important to patients than physical contact, many are also very unconcerned with having their information in the cloud
• Price points are similar for most available options (makes things easier)
• You can adapt one technology and one solution to many different stakeholders

ACTION ITEM

• Strive to change consumer attitudes towards healthcare delivery

BEST PRACTICE

• Reimburse only for the best pathway of healthcare delivery
• Artificial Intelligence (AI) is used for determining models and learning from them
• Find an enterprise based analytics solution located within a clinical setting
• Speed up ingestion and analytics of data
• Find the balance between one on one and subscription based model
• Retail clinics have an opportunity to provide a positive impact for minor issues
• A lot of different parts when it comes to chronic care leads to new models,
• While many in the field are reducing interaction with it, the FDA is still a central player; you need to worry about the FDA
• The first conflict point will probably be provider-payer not consumer-payer
• Cloud is the new change that has to happen, there is just too much data to house physically

FINAL THOUGHT

With the coming influx of technology and the growing consumer adoption rate, you need to really position yourself within the field and make use of the tools and analytics that are becoming increasingly more available. Cloud storage and the upcoming use of AI to help interpret all of this data in a meaningful way will be the key to success.

Q and A with
Sam Van Alstyne
Global Marketing Manager
New Products
3M Drug Delivery Systems

By Patricia Jacoby

Publications Editor 
Frost & Sullivan 

As new options in connected healthcare continue to emerge, new and sometimes unlikely entrants are also contributing to the transformation of the medical business landscape. To address this trend, Frost & Sullivan recently posed a few questions to Sam Van Alstyne, Global Marketing Manager, New Products, 3M Drug Delivery Systems. We discussed 3M’s entry into digital healthcare, their recent innovation in drug delivery and the need for effective business models to address all the changes in healthcare.

1. Can you describe your current role at 3M?

I am the Front End Innovation and New Products Marketing Manager for 3M Drug Delivery Systems Division.  My job is to work with our laboratory scientists, insights specialists and designers to develop new product concepts and take them through the commercialization process. I’m currently working on three projects – one, the 3M™ Intelligent Control Inhaler has been publicly announced.

2. Can you share any examples of new Drug Delivery Systems you are particularly excited about? 
  
The entry of 3M into digital healthcare – particularly as it applies to inhalation drug delivery.  3M is known globally as an innovative company and developed the first metered dose inhaler 60 years ago – it is exciting to see these come together. 

3. Can you discuss how 3M Science is being applied to Digital Heath Care?

It’s the theme of uncommon connections – the ability to bring resources from across the company to bear in solving a particularly tough problem. With our inhaler project, we can leverage formulation and delivery expertise from our own division, data management and analytics knowledge from 3M Oral Care and Health Information Systems Divisions to create a product that may help solve the persistent problems of medication adherence and what we call device competence – the ability of a patient to use an inhaler correctly.

4. How do you see 3M’s products and services evolving to meet the current shift to value-based healthcare?

Data plays a critical role in value-based care.  You must prove outcomes – not just clinically but in the real world and data helps to do that.  One of the benefits of connected devices is that you generate longitudinal data from a large and diverse population. Instead of days or weeks of data, you can get months and years – something that would be prohibitively expensive to do in a clinical setting. That data can be examined for trends and connections providing insights not only to healthcare providers but back to the patient themselves. Empowering patients is key to reducing healthcare costs in the long term.

5. Many new opportunities exist for companies (like 3M) focused on technology and process innovation. What opportunities for technological innovation do you see in the marketplace?

Globally there is intense pressure to reduce the cost of healthcare. Sometimes this seems at odds with the desire for new, innovative products – but it’s exactly from these sorts of tensions that true creativity flows. We have a challenging situation with drug delivery since most (if not all) of the payer-quantified value comes from the molecule delivered rather than the technology which delivers it.
Yet across the industry, there are patients who do not get the full benefit of their therapy because they forget to take their medication or they take it incorrectly. In these cases, the delivery systems can help. They can remind or remove obstacles by simplifying the administration process. These devices can provide real, demonstrable value to the patient and to the payer but it’s difficult to get additional reimbursement.

6. How about improvements that can be made to the drug delivery process?

It’s not just a problem in drug delivery, I attend several digital healthcare conferences each year and I’m always amazed by the incredibly creative solutions on display and most are struggling to survive.The desire, drive and technology are there, what’s missing are the innovative business models that help turn these inventions into sustainable businesses.

7. The theme of this eBulletin is Capitalizing On New Business Models in Healthcare for Breakthrough Results. Do you think that is possible?

Who will pay for the innovation seems to be the question on everyone’s mind.  Instinctively, we turn to the payers as that is their traditional role but ways to deliver care are evolving faster than the industry can adapt. Models based on share-of-savings are popular but defining and proving what the savings are remains challenging. Looking beyond the payer and understanding who benefits, how they benefit and finding ways to partner is the way forward in my mind.
 
Excited by the ways technology can improve healthcare outcomes, Sam Van Alstyne is a software engineer who ventured into marketing and has since become passionate about digital health.  As new products marketing manager in 3M’s Drug Delivery Systems Division, Sam has responsibility for the 3M Intelligent Control Inhaler program.

Medtronic: From Medical Devices to the Transformation of Healthcare

By Hugo F. Villegas
President
Medtronic, Latin America







Medtronic is evolving by innovating in new ways and collaborating with new partners around the globe to bring meaningful innovations to market, finding ways to align value among the system’s stakeholders, and increasing access to care around the world.

Medtronic has the point of view that healthcare systems globally are not sustainable as is. New approaches and new forms of innovation are required to face the current challenges and assure that millions of people around the world are not left untreated.

Hugo F. Villegas, president of Medtronic in Latin America shares his views and the Latin American perspective, “We know that universal health should be a must, and Latin America has made huge progress in that realm as more and more countries in our region have implemented health reforms and policies aiming to achieve access to health for their entire populations; countries have even made universal access to healthcare a constitutional right. However, an aging population, the increasing prevalence of chronic diseases, fee-per-procedure payment approaches and delivery systems with misaligned incentives all contribute to the challenges in meeting the universal healthcare needs.”

In Latin America, Medtronic has taken important steps to start the conversation on an approach, known as value-based healthcare that could address these issues. Simply put, value is the idea of delivering better outcomes at a lower cost. We’reactively engaged with hospitals, payers, healthcare authorities and governments, associations, think tanks and the academia in order toexplore how the data and insights that Medtronic’s technologies create can be combined in partnership to help establish aligned value-based healthcare models.

“We currently entered into agreements to implement value-based healthcare projects in Colombia, Chile, Puerto Rico and Brazil. We believe these projects will deliver high quality care for diabetes and cardiac patients,” commented Mr. Hugo Villegas. He added, “Through these agreements, we hope to learn more about what works and share those results as a means of encouraging more private and public actors within the healthcare ecosystem in our region to implement thesenew kinds of models.”

Medtronic technologies and services, combined in partnership with healthcare system stakeholders, can create improvement in models of care and care delivery for specific populations of patients.  When incentives are aligned and payment is linked to outcomes, value creation can be measured and value-based healthcare models are possible.   “We’re exploring alternative payment models that reward value over volume” emphasizes Mr. Villegas. 

Medtronic is known for delivering high clinical value with the company’s innovative technology portfolio. We are now more and more focused on providing economic value throughour services and solutions offerings.  The proposed re-architecture of the healthcare payment and delivery systems seeks to reward patient outcomes by re-shifting the current fee-per-procedure approach to one that puts the patient at the center of care and rewards patient outcomes over volume of procedures.

As the world’s largest medical technology provider, Medtronic has a unique role to play in the move toward aligned, value-based healthcare.We also recognize that no single entity can do this alone. Only through collaboration and partnership can we transform healthcare. “We call this approach Further, Together. ‘Further’ because we will continue to drive progress in innovation and formulate powerful solutions with proven clinical and economic value as the basis of our offerings and ‘Together’ because we will forge new and stronger partnerships to help our customers to achieve their goals, deliver clinical outcomes to the patients and reduce costs” finalized Mr. Villegas.

HUGO F. VILLEGAS has been President of Latin America for Medtronic since January 2015. Hugo is responsible for the operations and business performance of the region with commercial operations in more than 35 countries. From 2013 through 2015, he was President of Latin America for Covidien, which became part of Medtronic in 2015.

Villegas began his 28 year career in sales for Johnson & Johnson, after which he held positions of increasing responsibility, from marketing to general management. He was Country Manager for J&J Peru and J&J Venezuela and subsequently led regional marketing for the company’s Cordis division. Villegas then became Regional Vice President of Johnson & Johnson Latin America and from 2006 until 2013 Villegas was transferred to Madrid, Spain as Regional Vice President of Johnson & Johnson Europe’s Medical Technology.

In 2013 Villegas brought a strong strategic vision and passion for growth and became President of Covidien Latin America. Under his leadership, Covidien’s regional business accomplished double digit growth. After Medtronic’s acquisition of Covidien in early 2015, he became President for the new, expanded operations of both companies across the continent.

Why the Connected Patient is the Killer App in the Digital Age of Medicine

If you search on the phrase “killer app”, you will find a definition along the lines of a feature, function, or application of a new technology or product that is presented as virtually indispensable. The two essential components of the killer app being:

1. Competitive features and function
2. Indispensability

Before diving into the healthcare part of this, it is worth mentioning one of the all-time great killer apps in consumer technology: The Sony Walkman.

Unlike the stereo system in your bedroom, it fit into a backpack, and you could take it with you. Additionally, you could listen to music of your own choosing whenever you wanted, as opposed to whatever the radio played. And by 1983, cassette tapes had outsold vinyl—so you could get virtually any album to play on it, which made it even more indispensable in the market.

Competitive Features and Functions in Medical Technology

Considering some of medtech’s great killer apps over the last 15 years—from remote monitoring systems for cardiac pacing to molecular diagnostics using the human genome—there is a common denominator that threads across the features and functions of these products. Simply put, they have slowly but surely become more centered around individual patients and their lives.

Whether it was the Bluetooth-enabled data uploads that were patient-triggered (from the nightstand!) in early remote monitoring or the patient’s own biology that led to improved diagnosis, it’s easy to identify “patient-centric” features and functions. But historically, a practical challenge to even the most novel diagnostics and therapies becoming indispensable in the market was that patients had minimal role in determining product value.

This is rapidly changing in the digital era.

How the Connected Patient Will Define Value in our Future
 
Alec Ross, the author of NYT bestseller Industries of the Future, has an intriguing way of looking at our eras of progress and the markets that revolved around them—basically, it comes down to raw materials and who has owned them. In the agricultural age, landowners owned the farmland; in the industrial age, corporations owned the iron.

Today, in the digital age, individuals own data. And in the digital era of medicine, patients and their data underlie the volume-to-value transformation…starting right now.

Why now? Because every single connected consumer in the US is a patient at some point. But as importantly, patient-consumers have integrated healthcare into their daily lives and are exhibiting new behaviors because of it. For example, Google has reported that “healthcare where and when I want it”-type searches have surged since 2013, and in 2016 the majority of health-related searches shifted from web to mobile for the first time in history.

If healthcare technology is becoming integrated into the real life of patients, the way we measure health outcomes should reflect this shift.

This takes us full-circle, back to patients and their digital data and why they are key to our value-based future—with their help, their data can be used to quantify and enhance health outcomes outside of clinic walls, so we can finally see what’s working, or not, in the real life of patients. And if real life patient data is redefining health outcomes, and outcomes are the basis of value-based care, then connected patients are the virtually indispensable component of healthcare in the 21st century. I.e., the connected patient is the killer app in the digital age of medicine….as the famous Sony Walkman ad said, “There’s a revolution in the streets.”

Deborah Kilpatrick, Ph.D., is an executive with broad experience in development and commercialization of new medical technologies and products for primary care and specialty channels. Her operational roles have spanned domestic and global leadership in R&D, corporate strategic planning and new technology incubation, as well as marketing, sales, and reimbursement in Fortune 500 and Silicon Valley start-up healthcare companies. 

Richard Milani, Chief Clinical Transformation Officer at Ochsner Health System, is also Vice-Chairman, Cardiovascular Diseases at Ochsner Health System. He has helped to shape and lead the Ochsner organization for almost eighteen years.

Ochsner Health System is an Evidation Health partner and Louisiana’s largest non-profit, academic healthcare system. To learn more about their medical expertise and innovationOchsner’s digital health capabilities, visit ochsner.org and https://www.ochsner.org/io

To learn more about how healthcare companies are using Evidation Health’s Real Life Study Solution to quantify health outcomes in the digital era of medicine, follow @evidation.

Navigating Through a Landscape of Change at the 22nd Annual Medical Technologies: A Frost & Sullivan Executive MindXchange

                       

 

Amid an eclectic, global crowd of key healthcare industry leaders, medical technology experts, and seasoned business entrepreneurs, two constant event themes emerged early on: uncertainty and adding value to the healthcare continuum.  Moreover, keynote speaker address titles included long tail key phrases like, Adopt or Die, and Changing Channels, or Adoption of New Technology. Each keynote address introduced well-documented evidence pointing to an emerging era of unprecedented change in healthcare and the struggle to find business strategies that adds value for advanced medical technology in a value-based healthcare ecosystem.

This survival of the fittest mentality combined with the movement to value-based care dominated not only the main sessions of the 22nd Annual Medical Technologies: A Frost & Sullivan Executive MindXchange, but also subsequent follow up conversations at lunch, dinner and into the night as colleagues and new friends gathered in small groups to debate the way forward. This heightened level of dialogue and sense of urgency continued for over three full days of interactive sessions and team-building exercises orchestrated by the Frost & Sullivan Events Division.

In addition to the ever present “winds of change” presentations, there were also brief presentations about seismic shifts in advanced medical technology. These discussions involved early detection and prevention of chronic and degenerative disease and the endless opportunities medical devices bring. But, break-out session facilitators went on to explain this anticipated scientific and financial bliss from advanced medical technology requires unique applications where providers can successfully detect, intervene and prevent debilitating diseases. In essence, the ability to create a blue ocean strategy for the planned data output of a new medical device. However, capitalization for mimic medical devices is challenging as is raising money for medical devices whose product produces scientific data that has little or no clinical relevance. A reported missed step when beginning a first round of capitalization is not having a planned and granular business strategy with enough follow- through to generate a return an investment for investors.

How Technology Becomes Business and Business Becomes Technology

Al Naqvi of The American Institute of Artificial Intelligence gave an in-depth presentation on the advancement of artificial intelligence and its many applications in medicine. He simultaneously encapsulated the necessity for finding a business strategy for technology and showcased how artificial intelligence is transforming the healthcare value chain.

Since the first industrial revolution in the 1750s, technology and business have been viewed as separate entities. This is referred to as strategic dualism where technology enables business. In the latter 1800s, electricity created a division of labor and mass production that enabled mass distribution. This dominated an acceptable parity between technology and business until late in to the 20th century. Then, with the dawning of information age technology, the introduction of the Internet generated a cognitive and consciousness revolution that established a reality that technology is now both the core business and strategy and that the two are indistinguishable (Cognitive singularity).

In short, machines are no longer viewed as detached inanimate objects designed solely for mass production. And with this admission we usher in the artificial intelligence (AI) revolution where we have:

 

Artificial Intelligence
 
For applications of AI along the healthcare continuum, Mr. Naqvi suggested ways AI can shape this opportunity. As Naqvi stated "You need to ask yourself these questions. What text or data can be extracted? What machine learning can be deployed to learn processes such as caring, diagnosing, and providing therapy? And lastly, how much learning can be integrated with workflows?" Naqvi then stressed the imperative for AI to contribute to healthcare by adding value. Without transforming the value chain and a sound business strategy, even IBM’s Watson is viewed as nothing more than a computer.

A Call for Ethics in Technology – Adopt or Die

Michelle Mosolgo, Chief Technology Officer, Healthcare Solutions and Services, Merck & Company, presented an emerging ecosystem for new technology adoption and outlined four linear and concurrent parameters required for cultural and industry acceptance. What was the impossible is now the expected:

1. Channels: moving away from existing and traditional channels of mobile access, websites, and social media to real-time social platforms including Facebook Live, Google Allo and voice-driven SEO and new media such as Netflix and Apple Music along with location technology innovations like Waze

• Distancing themselves from type-and-read contextual searches of the past 20 years, new connected home devices including Amazon Echo & Google Home introduce an audio component in to search queries. As a direct result, voice-driven search results provide a more sophisticated level of analytics that can provide businesses targeted solutions.

2. Product: the industrial revolution brought with it mechanical designs created by engineers. Today’s products call for Human Centered Design (HCD) which is a process on to itself which involves customers throughout the product and service design exercise. Customers can now celebrate with products that meet their lifestyle needs resulting in true perceived value that brings a much quicker and sustainable return-on-investment algorithm. With many lessons learned, adoption of technology is now more prevalent and more user friendly dictating the need for principles moving forward.

• Product Principles

• Price Point
• UX/Design
• Clarity of Purpose
• Privacy

3. People: integrated experiences must come first  and place the human in the center. Amazon is experimenting on a number of frontiers in this regard including the application of mini-drones to deliver goods and grocery shopping without challenging and annoying check-out lines.

4. New Business Models: this new and exciting frontier will blend educators with businesses who face the daunting task of simultaneously educating students and teaching employee skills to solve problems industries have not yet encountered.

TAKE-AWAY

• 64% of patients would see a doctor via video
• Access and convenience is more important to patients than physical contact, many are also very unconcerned with having their information in the cloud
• Price points are similar for most available options (makes things easier)
• You can adapt one technology and one solution to many different stakeholders

What remains is the defining of the delicate balance of technology and ethics required to oversee myriad applications for faster, smarter, and better products and services. Who decides if it is ethical for a sensor in modern vehicles to decide which of 4 passengers will survive when it deploys air bags? These are ethical questions which industry leaders and consumers must debate and solve.
 

Venkat Rajan, Global Research Director-Visionary Healthcare, Frost & Sullivan,
leads the global program focused on disruptions and transformations occurring within the healthcare sector. He directs content delivered through the interactive analysis of ecosystem maps, diagrams, scenario planning, best practice case studies, market monetization modelsand provides commentary on other topics related to a converging marketplace.
 

Patrick Riley, Senior Healthcare Analyst Frost & Sullivan, investigates and writes in the Advanced Medical Technology healthcare industry vertical globally. Currently, he is authoring a study on the Future of Robotic Assisted Surgical Devices. He is also working globally on studies evaluating the utilization and application of permanent synthetic mesh used in laparoscopic surgeries.

Patrick is also involved in Frost & Sullivan's Transformational Health effort, writing and conducting research on healthcare reform and the impact of the Patient Protection Affordable Care Act.