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Convergence of Medical Devices, Telehealth, and eDisease Management Presented at SAINT IEEE Workshop on Global Telehealth/Telemedicine & the Internet San Diego, CA January 9, 2001 Vince Kuraitis JD, MBA Principal, Better Health Technologies www. bhtinfo .com (208) 395-1197

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Page 1: Convergence of Medical Devices, Telehealth, and eDisease Management Presented at SAINT IEEE Workshop on Global Telehealth/Telemedicine & the Internet San

Convergence of Medical Devices, Telehealth, and eDisease Management

Presented at

SAINT IEEE Workshop on Global Telehealth/Telemedicine & the Internet

San Diego, CA January 9, 2001Vince Kuraitis JD, MBA

Principal, Better Health Technologieswww.bhtinfo.com (208) 395-1197

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Clicks and Bricks

InternetTechnology

Services/Bricks

500 100

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Presentation Overview

• Background and Terminology

• Emergence of Remote Monitoring

• Strategy and Business Model Design

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Background and Terminology

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Better Health Technologies

• Strategy, business models, partnerships• Disease/care management and e-health • Consulting/Business Development

• E-Care Management News– Complimentary e-newsletter– 2,500 subscribers in 27 countries worldwide– www.bhtinfo.com/pastissues.htm

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Recent BHT Clients• Pre-IPO Companies

– Life Navigator (remote monitoring connectivity and health intermediary services)– DiabetesManager.com (Internet diabetes DM)– CogniMed (highest cost/risk patient management software)– Caresoft (consumer focused DM)– Benchmark Oncology (oncology DM)– SOS Wireless (cellular phone technology)– Click4Care (Internet DM)

• Established organizations– Medtronic -- Neurological DM (medical devices/chronic disease solutions) -- Cardiac Rhythm Patient Management– Disease Management Association of America (trade association)– PCS Health Systems (PBM)– Varian Medical Systems (oncology equipment & systems)– VRI (behavioral health care management services)– Washoe Health System (integrated delivery system)– S2 Systems (medical transaction processing software)– CorpHealth (MBHO)– Physician IPA– Centocor (biopharma)

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5 %

4 5 %

5 0 % 3%

37%

60%

% of population % of claims

Distribution of Health Care Claims In A Population

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Cost Per ClaimantPer Yr.

0 10 20 30 40 50 60 70 80 90 100

$1,000

$0

$2,000

$3,000

$4,000

$50,000

$75,000

$100,000

Claimant Percentile

Distribution of Health Care Costs: Conceptualizing Population Health

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$$ Per ClaimantPer Yr.

0 10 20 30 40 50 60 70 80 90 100

$1,000

$0

$2,000

$3,000

$4,000

$50,000

$75,000

$100,000

Disease Management Services

2 Differing Approaches Emerging

eDM/eCare Management

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Differing Value Propositions

DM Services• Care Coordinator = 3rd Party• Cost containment• Save $$ short term on behalf

of health plan• Prevent unnecessary

hospitalizations and ER visits• Done “to” the patient• 5-10 top diseases• Local/regional focus

eDM/eCare Management• Care Coordinator = patient• Health care consumerism• Save $$ long term on behalf

of the patient• Optimize patient health status

• Done “by” the patient• 100+ conditions/diseases• Not geographically bound

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Emergence of Remote Monitoring

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• A Portable Cure: PDAs for drug research and prescriptions are getting attention

• Enhancing Patient Care: In-hospital wireless monitoring

• Freedom From Hospitals: Remote monitoring of chronic illnesses

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Types of Remote Patient Data

• Biometric– list

• Patient satisfaction• Subjective symptoms

– Pain– Fever– Shortness of breath– Etc.

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Characteristics of Remote Monitoring (RM) Data

• Real time• Multiple sources

– Across multiple devices– From the patient

• Subjective• Patient satisfaction• Passive (gathered by the device)

• Integrated with other data across multiple providers, e.g., EMR, lab, pharm, claims

• Longitudinal• Data warehouse, data mining opportunity

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Timing of Biometric Data

• Quarter-to-Quarter (q/q)• Month-to-Month (m/m)• Week-to-week (w/w)• Day-to-day (d/d)• Hour-to-hour (h/h)• Minute-to-minute (m/m)• Second-to-second (s/s)

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4 Cs of E-Health

Connectivity

Content Commerce

Care

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A Crude Map of the New World: eHealth & Care Management Framework

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A Crude Map of the New World: eHealth & Care Management Framework

PersonalOnlineMedical Record

eDisease Management

ElectronicMedical Record

DiseaseManagementOutsourcingServices Telemedicine

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Strategy and Business Model Design

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© www.bhtinfo.com11/21/00 Life Navigator, Inc. 4

Fragmented RM Market

Etc.

Providers

Employers

Consumers

DM/eHealth Vendors

HealthPlans

TelemedCompanies

MedicalDevice

Companies

eHealth

Internet Appliance

Wireless

Telecom

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LNI Value Proposition

Etc.

Providers

Employers

Consumers

DM/eHealth Vendors

HealthPlans

TelemedCompanies

eHealth

Internet Appliance

Wireless

Telecom

MedicalDevice

Companies

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Multiple Sources of Revenue

• Sponsorship Fees• Advertising• Health Data Fees &

Infomediary Sponsorships• Marketing & Product Launch

Fees• Pharmaceutical

Sponsorships• Clinical Trial Recruitment• Electronic Prescriptions• Pharmacy Sponsorships• Delivery of Health Care

• Directory Advertising (provider and non-provider)

• Consumer Advice and Research Services

• Online Disease Monitoring and Disease Management Services

• Disease Testing Services• 2nd and 3rd Opinions• E-mail Reminder Notices• Health Claim Assistance• Direct

Source: Business model for DiseasesRx.comhttp://corporate-partnering.com/names/clicks-to-bricks-business-model.htm

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InternetTechnology

Services/Bricks

500 100

Marginal Cost Per Unit of Service

Scaleability

Valuation

Operating Model

IT

Connectivity

Value Proposition

Geography

Close to zero High

Hi Lo

8-15 x Revenues 2-3 x Revenues (valid in 3/2000, not today!)

Web enabled tools Services

ASP Client/Server

Internet Fax, phone, mail

Ride the wave Identify leverage points

of health consumerism of behavior change

Ubiquitous Regional markets

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Key Questions to Consider

• Where are you today?• Where are you headed?

– Direction?– Speed?– Momentum?

• What is the optimal mix of bricks and clicks?• Are any extreme business models viable?• Where will contemplated capital investments move you?• Should you make or buy Internet technologies?

InternetTechnology

Services/Bricks

500 100

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END