r bleddyn v rees international opportunities for healthcare services, research & innovation

International opportunities for healthcare services, research & innovation

R. Bleddyn V Rees •  Non Executive Director – European Connected Health Alliance •  Partner, Head of International Healthcare – Wragge & Co LLP

Presentation: South East Wales Academic Health Science Partnership

10 January 2013

Name of Speaker, Position

1. Who am I?   Lawyer & Head of Healthcare at Wragge & Co LLP, an

international law firm. (NB separate Pharma & Life Sciences team).

  Seconded to Department of Health for 3.5 years as General Counsel of the Commercial Directorate.

  Non-Executive Director of the European Connected Health Alliance & industry advisor for English AHS Network.

  Advise the Departments of Health of 6 countries, NHS Commissioners, NHS Foundation Trusts, private health & social care businesses, local authorities, housing associations, charity & voluntary sector, Pharma, life sciences & technology business.

  My home is in Cardiff.


2. What is the European Connected Health Alliance?

Not for Profit Company

Europe’s largest Connected Health Membership

Organisation

Sets up Ecosystems to deploy Connected Health & transfer

best practice & solutions from region to region

Membership includes Departments of Health,

Hospitals, Care Homes, GP’s, Commissioners,

Universities & Industry

Promotes the deployment of Connected Health (devices &

services) at scale on commercial terms

2 1

3 4

Provides International leadership

for the development of Connected Health – has

international Advisory panel 6 5


The Compton ‘Circle of Care’

The Northern Ireland System & Model Integrated Health & Social Care

3. What is Healthcare?

WHO defines health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.


4. International Healthcare & Comparisons : What does good look like?

Country

Per capita expenditure

on health (USD)

Healthcare costs as a percent of

GDP

% of government

revenue spent on

health

% of health costs paid

by government

Life expectancy

Infant mortality

rate

Physicians per 1000 people

Nurses per 1000 people

US 7,290 16% 18.5 % 45.4 % 78.1 6.7 2.4 10.6

Norway 5,910 9% 17.9 % 83.6 % 80 3 3.8 16.2

Canada 3,895 10.1% 16.7 % 69.8 % 80.7 5 2.2 9

France 3,601 11% 14.2 % 79 % 81 4 3.4 7.7

Germany 3,588 10.4% 17.6 % 76.9 % 79.8 3.8 3.5 9.9

Sweden 3,323 9.1% 13.6 % 81.7 % 81 2.5 3.6 10.8

Australia 3,137 8.7% 17.7 % 67.7 % 81.4 4.2 2.8 9.7

UK 2,992 8.4% 15.8 % 81.7 % 79.1 4.8 2.5 10

Japan 2,581 8.1% 16.8 % 81.3 % 82.6 2.6 2.1 9.4

Source: OECD Health Data 2007


5. Drivers for International Opportunities

  The beginning of a global healthcare sector/industry?

  Increasing role of WHO, UN and EU in healthcare?

  The wealth of certain Middle East countries.

  Disruptive technology & business models (Clayton Christensen).

  The needs of the developing world, especially the absence of traditional health infrastructure (hospitals and primary care facilities) enabling disruptive technology.

  The pump priming activities of the global telecommunications and technology industries.

  NCDs & Aging population.


A shared driver for people & society

from reactive

health management

to proactive

health management


6. Middle East opportunities: Some examples   Privatisation of existing general hospitals, e.g. United Arab Emirates initial

management contracts for:

- Johns Hopkins - Vamed

- Cleveland Clinic - Bumrungrad

  Outsourcing of the running of new hospitals, e.g. Saudi Airlines/Riydah & Royal College of Surgeons Ireland & Bahrain.

  Partnering/JV arrangements for specialist services e.g. Guy’s & St Thomas are bidding to set up and run a cancer hospital in Qatar.

  Partnering to set up and run a new ‘World Class’ Medical School for KUSTAR in Abu Dhabi.

  Research & Development funding & programmes & endowments, e.g. Etisalat/BT/Khalifa University Innovation Centre (EBTIC).

  International private patients (including government programmes) treated in the UK.

  Consulting services.


Other Global examples: (1) Abu Dhabi a living laboratory… “Big enough to ma.er, small enough to manage…”: 2.4m popula:on, 18,000 clinicians, 1,367 facili:es

Highly strategic government with broad‐based popular trust (use of data)

Extreme pace and depth of development, and environment broadly, and rapid health reform

“Sufficient complexity” to be broadly applicable: Mul:ple payer – Mul:ple provider

Rela:vely well‐resourced


Weqaya reports • 110,000 individual reports sent to home addresses • Individual Weqaya Score and risk factors • Informa:on, basic ac:ons, brief message, separate informa:on booklet

Weqaya Helpline (800 61116) • Booking appointments (SMS reminders and re‐call) • Answering Weqaya programme queries

Weqaya website (BETA) • Access to Personal Data • Interac:ve, recommenda:ons based on risk level • Appointment booking op:on • Links to DMPs • Links and recommenda:ons for non‐health sector interven:ons • General informa:on on healthy living for Weqaya and general public

We’ve already established a range of feedback channels


We’re seeing lots of innovation in measurement and behaviour change technology Measuring health

•  Opt‐out screening •  Opt‐in data sharing

Taking health promo:ng ac:on

•  Ubiquitous Weqaya programme

•  Disease Management Programmes

•  Point of decision prompts, e.g., Weqaya label on healthy food

•  At home monitoring •  Secure data sharing


7. Other Global Examples

(2) Moorfields Eye Hospitals & Mobile PHF records in Africa.

(3) Etisalat – access to records and midwifes via mobile for pregnant mothers in Africa.

(4) Nike Fuel Band – Wellbeing & retail.


(4) Nike Fuel Band: Well being data & tracking

:Share with friends :Compete against friends

Motivation


7. Other Global Examples (5) Growth of new services for wellbeing

  Hea!thrageous (www.healthrageous.com)

  Wellocracy (building community around connected health for every day citizens)

  Objective data in feedback loops and the use of motivational psychology

  “I can’t eat fudge because I can’t fudge my data”

  First e-book 8 January 2013

  www.patientslikeme.com

(6) “Expert patients” self managing long term conditions, keeping stable if not well and avoiding expensive admissions/hospital treatment.


(7) Our devices evolve towards the SoulMate

CPU

SPU

Smart Phone Liferecorder

SoulMate


Every move counts, whatever the activity Socializing within a health related service drives up motivation

(8) Heia Heia - Social Wellness

Walking the dog is the 5th most popular activity in Finland


Secondary care

Community care

Primary care

Domiciliary services

Assisted Living services

Care Homes services

  Health and social care providers

  Technology devices, equipment and services

  Consumer healthcare products and services

Industry

Commissioners of Healthcare Commissioners of Social Care

•  Pharmaceutical •  ICT software (telecoms)

equipment and services •  Research

CONSUMERS

PATIENTS

PEOPLE

US

Public Providers University & Research Organisations

8. What is a Connected Health Ecosystem? Dictionary – “a system involving the interactions between a community and its non-living

environment.”


Health & Social Care Commissioners

Health & Social Care Providers

Public Providers

Secondary Care

Community Care

Care Home

Assisted Living

Primary Care

Private Providers

Patients, Families, Citizens

Higher Educa:on Research Base

Industry

Technology Devices & Services

ICT & Telecoms

Software

Services

Pharma

Integration

The Manchester Ecosystem

Ope

n In

nova

tion

Part

ners

hip


  Organised around the Manchester Academic Health Science Centre (MAHSC), one of only 5 UK Department of Health approved partnerships between NHS Hospitals and the clinical teaching and Business schools of a University.

  MAHSC comprises the 5 major Manchester hospitals (a mental health, cancer and 3 Tertiary District General Hospitals) and the Business School and clinical teaching schools (including medicine, nursing, optometry, pharmacy and dentistry) of Manchester University.

  Includes Manchester Digital Development Agency, Greater Manchester Research Network and the University of Manchester mHealth Innovation Centre.

  Includes GP practices (as providers) and GP’s as Commissioners.

  Includes Housing Associations ‘connecting’ health and housing and social care.

  Includes Local Authorities as the commissioners of social care.   Includes the ECHAlliance industry members who provide potential ideas,

solutions and services.

8. The ECH Alliance Manchester Ecosystem


8. The ECH Alliance OuluHealth Ecosystem (Finland)

Industry focus areas Wireless Health Monitoring

eg. remote diagnos:cs

Individualized Healthcare eg. assisted living, mental health

Genes and Lifestyle

PaLents, Families, CiLzens

Health & Social Care Providers Public Providers

Private Providers

Business Model

Oulu InnovaLon Alliance (OIA): Oulu University, Oulu Univ. of Applied Sciences, City of Oulu, VTT &

Technopolis 5 OIA InnovaLon Centres, eg. CHT

Centre for Health and Technology

Funding : City of Oulu, Social and Health Ministry, Tekes, Sitra, EU, etc.


8. ECH Alliance Ecosystems – What are they all about?

Developing existing networks Focusing on doing rather than just talking Connect to the ECHAlliance international network

Barcelona


Health & Social Care

Services

Education &Training Research

Ecosystems: a driver for integration & economic development with

HEALTHCARE AS AN INVESTMENT NOT COST.

8. ECH Alliance Ecosystems – What are they all about?

Engine for investment growth and economic development


9. Challenges   US Teaching Hospitals have very professional and formidable sales

skills.   US healthcare standards are being adopted to train tomorrow’s

doctors.   NHS is late to global opportunities and a little arrogant   The NHS brand is not always an exemplar!   Culture, e.g. Middle East Sheria law, beaurocratic procurement

process and obtaining payment!   Competition between NHS organisations abroad (cf Lord Darzi).   World class standards, comparative system reviews & management

consultants.   Complexity of systems, laws and lack of transparency?   Clinical & Financial Evidence v risk management.


“The patient is the most underused resource in medicine” e-Patient David deBronkart

Tim O’Reilly

A communication gap between healthcare pros and patients


A potent service design combo

Wearable sensing Minimal personal input

Aggregated meta data presented in motivational

form

Wellness transformation


10. ECH Alliance: How can you help us?

  Become members! (www.echalliance.com)

  Tell us about any ideas you have to improve patient services.

  Tell us about any solutions (devices or services) you would like to deploy in our Ecosystems.

  Help us make our Ecosystems a success. Questions?

[email protected] www.wragge.com