Monetizing Health Information: Opportunities, Risks and Realities Thursday 3 December 16.15 – 17.30 Christopher Park
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How technology and cross industry working are transforming patient care today and tomorrow Healthcare and Life science predictions 2020
How digital technology is transforming patient care today
Disrupting traditional healthcare and life science industries
Let’s dig deeper and see how Med Tech companies are positioned to capitalize on the various data-driven opportunities in the market
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The health care ecosystem To fully capitalize on the potential value of their data, medtech companies must create and tap into health ecosystems
Pharma Medtech
Govt. & Regulatory
Care Provider
Consumer
Pharmacy
Economic Factors
Medtech companies are in a unique position to create and capitalize on the health ecosystem due to their direct engagement with patients and the great volume of valuable clinical data they gather
Payers
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Data and the choice cascade Medtech companies should be rigorous in developing approach to capitalize on data What are our goals and aspirations?
What does success look like for our company in the future medtech environment?
Where will we play? How will we win in chosen areas?
What part of the market will be targeted? Who are the users and customers?
How will we strategically differentiate ourselves v. the competition?
Focus will be placed on these decision points, though consideration should be given to other questions as well medtechforum.eu
What are the supporting capabilities needed?
What must we build / buy to enable our success?
How will we measure success?
How do we gauge our success and make sure that we continue to be successful?
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Where in the Data Universe does your data reside? Specificity
Individual Patient
Predictive
Suppliers Real Time
Historical Quantitative
Aggregators
Typology Qualitative Structured
Unstructured
Aggregated Consumers
Order
Marketplace Brokers
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Key Players in the Health Care Data Landscape Category
Data Capture
Data Aggregation
Analysis
Intelligence Operationalization
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Description of Capabilities
Example Organizations
Capture complete and accurate data within and outside the health system in a timely manner
• • • •
Govern and aggregate data from disparate systems for analysis
• Pharmacy benefit managers • Robust EMRs • Simple health plan capabilities
Develop actionable models based on diverse data input; may include predictive analytics
• Robust health plan capabilities • ERP and SAAS companies • Health data aggregators
Enable use of insights in patient care tailor dashboards to stakeholder needs and assist in care coordination
• Robust health data managers • Health cost modelers and data sales providers / specialists
Simple EMR capabilities Pharmaceuticals & CROs Pharmacies & point of sale In-patient / out-patient care providers
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Medtech’s unique opportunity Medtech companies should recognize the unique position they have to capitalize on health ecosystems and monetize their valuable data Typical Data Collected by Health Care Participant
Pharma
Care Providers
Payers
•
Clinical trial results
•
Patient care history
•
Claims data
•
Sales data
•
Clinical factors
•
•
Patient preferences
•
Prescribing trends
Costs and results information
•
Data from insurers (as available)
•
Patient response to treatments
•
Interactions
Medtech Medtech companies have the unique capability to capture information across categories, and realize the great potential value in combining this information. medtechforum.eu
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Competition from unexpected places While MedTech companies are well positioned, emerging competitors pose a competitive risk Non Traditional Players
Overview: Wearable technology companies, such as FitBit, have saturated the market and mobile health has become a key trend in the healthcare landscape Competitive Threat: The widespread popularity of mobile health reduces the typical barriers to entry into this market, allowing new entrants from wearable technologies and other technology companies to easily capture data and compete with experienced players in the space medtechforum.eu
Traditional MedTech Companies
Overview: Because traditional Medical Technology companies such as Baxter and Medtronic have products that are well positioned to collect data, these companies are naturally situated to capitalize on this opportunity MedTech companies are facing threats from new entrants into the market and need to capitalize on the data opportunity before the market becomes too saturated
Other Healthcare Stakeholders
Overview: Other healthcare stakeholders are coming up with innovative ways to capture and analyze patient data and are making significant investments to partner with technology companies and diversify product offerings Competitive Threat: Proteus Digital Health and Otsuka recently submitted an application to the FDA for approval of their innovative drug adherence device, allowing caregivers to monitor for drug consumption.
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Three opportunities for medtech companies Medtech companies may create several different types of opportunities using data… or risk getting left behind if they do not Three Types of Possible Opportunities
Take a bigger piece of pie
Create a bigger pie
Make a new pie
Use data collected through devices as a way of improving products and outmaneuvering competitors
Expand the overall market by using data to access current non-consumers
Create entirely new markets / businesses by monetizing the data collected
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There is still much to sort out Issues and risks directly impact the path to market and monetization Regulatory Risk How will regulators in your market impact the availability, dissemination and utility of clinicial data? Privacy Risk How might privacy regulations and practices evolve as the utility of patient ‘big data’ becomes more evident? Brand Risk How will providers, patients and business partners perceive and react to the expanding availability and use of data? Application/Utilization Risk How will you manage/monitor/control the downstream uses of data once disseminated?
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Case #1: Baxter Sharesource1 Baxter’s Sharesource employed smart, connected technology to address specific challenges facing the use of its hemodialysis devices • Baxter produces peritoneal (PD) and hemodialysis (HD) devices that are used in patients’ homes (and in clinics)
Background
• Historically, Baxter has been able to win in the home setting but sought to improve how care is delivered and to grow the home dialysis market
Challenges
Baxter
Care Providers
Patients
•
Creating supply chain reliability
•
Fulfilling patient and provider needs
•
Maintaining visibility into patients’ care
•
How to make adjustments to care as needed
•
Safety and reliability
•
Ease of use and operation
•
Ability to keep in touch with care providers
Value Delivered2
Approach Taken
Baxter introduced a modem into the devices, which monitored patient treatments, and launched Sharesource, a portal facilitating two-way communication between the devices and the care providers, and also providing guidance to the patient on operating the device. Through this Baxter will also be able to collect aggregate patient data to better understand usage and outcomes
•
Supply needs able to be efficiently and promptly met
•
Better insight into patient and provider usage of product
•
Better monitoring of patient care and progression
•
Ability to make adjustments remotely, resulting in better care
•
Ability to easily and safely administer care
•
Treatment from the comfort of their own homes
data medtechforum.eu Notes: 1) Example based on publically available information; 2) Statements have not been validated with outcomes 11
Sources: Baxter corporate information (http://www.viviahomehd.com/sharesource.html); (http://www.livenow.info/index.html)
Case #2: Fitbit Multiple Sclerosis Study1 Fitbit’s activity-tracking data could serve as an indicator of well-being and disease progression in MS patients, according to Biogen’s study • Fitbit is a market leader in “basic” wearables but has had trouble translating data into valuable outputs for consumers and health care providers
Background
• Biogen assessed the potential of Fitbit to track patient activity and increase activity overall
Challenges •
Fitbit
Care Providers
Patients
•
Maintaining growth in an increasingly competitive market Demonstrating ability of devices to improve health outcomes
•
Managing patients’ dynamic MS disease needs
•
Relying on often inaccurate selfreported patient information
•
Quantifying and reporting physical activity
•
Sustaining motivation to meet recommended health goals
Value Delivered2
Approach Taken
Biogen supplied Fitbit wristbands to 248 patients with multiple sclerosis. Individual activity levels and sleep pattern data generated by Fitbit were recorded to an online forum, revealing insights into each patient’s health on a daily basis and helping care providers better track the progression of the patients’ disease and their response to treatment.
•
Demonstrated potential for leadership in ‘chronic disease’ wearables
•
Improved customer buy-in, as 87% said would use after study
•
24/7 monitoring provided real-time understanding of patient progress
•
Objective results with greater accuracy than self-reports
•
Clear results that could be compared within online community
•
89% of participants said activity tracking helped manage health
Notes: 1) Example based on publically available information; 2) Statements have not been validated with outcomes data Sources: Medical Marketing Media: “Biogen, PatientsLikeMe use Fitbit to better understand MS”; Fierce PharmaMarketing: “Attention pharma laggards: FitBit 12 trackers delivered in Biogen’s MS movement study”; Bloomberg Businessweek: “Big Pharma Hands Out Fitbit to Collect Better Personal Data”
Case #3: Philips HSDP1 Philips created an open cloud-based platform that connects patients and providers to enable healthier living and wellbeing • Philips Accelerate! Transformation initiative drove a focus on acquiring and growing customerfocused companies within HealthTech
Background
• HealthSuite Digital Platform integrates data from a variety of sources including EMRs, diagnostic imaging and monitoring equipment, and personal devices to optimize health treatment outcomes while minimizing cost
Challenges
Philips
Care Providers
Patients
• Establishing itself as a leader in HealthTech • Addressing trends toward integrated and patient-centered care • Managing and modifying patients’ dynamic care needs • Consolidating extensive patient and population health data
•
Accessing their health providers
•
Managing their own health
•
Maintaining privacy and reliability
Value Delivered2
Approach Taken
Philips created the cloudbased HealthSuite Digital Platform, supported by Salesforce 1 Platform, to allow patients and their providers to collaborate in real time. The eCareCoordinator app gives clinicians daily objective and subjective health measurements from patients. The eCareCompanion app allows patients to input their medical device data and manage their own care.
•
Create cloud platform with scalable, adaptable, and mobile capabilities
•
Provide cost-efficient, effective health solutions to clients
•
Prioritize, monitor, and treat patients remotely
•
Receive recommended course of action based on clinical algorithms
•
In-home treatment
•
Assistance with pre-assigned health tasks
•
Data security and 24/7 technical support
data medtechforum.eu Notes: 1) Example based on publically available information; 2) Statements have not been validated with outcomes13 Source: Philips Healthcare corporate website
Connected Health How technology is transforming patient care today and tomorrow Thursday 3 December 16.15 – 17.30 Karen Taylor
medtechforum.eu
Deloitte UK Centre for Health Solutions Established in November 2011, the Centre for Health Solutions is the independent research arm of Deloitte LLP’s healthcare and life sciences practices. Its goal is to inform stakeholders across health care and life sciences about emerging trends, challenges, opportunities and examples of good practice. Using primary and secondary research and rigorous analysis to drive unique perspectives, the Centre seeks to be a trusted source for relevant, timely, and reliable insights. www.deloitte.co.uk/centreforhealthsolutions
blogs.deloitte.co.uk/health/ Publications
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In last 5 years healthcare systems in most countries have come under increasing pressure in terms of costs, funding, demand, supply, access and expectations with converging healthcare trends transforming the market
Increasing care complexity
Escalating healthcare costs
•
More expensive medicines
•
Increasing demand for diagnostics
•
Increasing staff costs
•
Expanding funding deficit
•
Demand for value
•
Aging population
A change in patient Expectations
•
•
Rising prevalence of multiple long term conditions
Patients expect and demand better quality care - cocreation
•
‘high and increasing • bed occupancy and delayed discharges •
Support needs to be patient-centred Desire to move to outcome based/value based funding
Evidence for use of TEC services
•
Mobile and digitally enabled technology increasingly now seen as a solution to overcome todays challenges improving: ‒ productivity ‒ efficiency ‒ cost ?
50% of the world's population don't have access to the very basic healthcare that they need Yet most have a device that they all carry, on which key aspects of healthcare can be delivered wherever they are medtechforum.eu 16
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How technology and cross industry working are transforming patient care today and tomorrow Healthcare and Life science predictions 2020
How digital technology is transforming patient care today
Disrupting traditional healthcare and life science industries
medtechforum.eu
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Centre for Health Solutions
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Patients becoming more like consumers? •
Globally, individuals are becoming better informed about their own genetic profile, more engaged in their health status, risks and prevention agenda and more likely to demand specific treatments.
Today’s evidence •
Increasing number of people comfortable consulting via video or skype. (US 64% willing to have a telehealth visit via video – (saving $126 per person)
•
Consumer access to EHRs increasing
Insurance companies/employers providing incentives that reward good behaviour
•
Increasing number of Government initiatives to empower patients via digital
Clinicians are becoming more actively engaged in use of digital technology
•
Increase in on-line patient communities PatientsLikeMe over 300,000 members/ 18 2,300 conditions.
•
In UK still only small % people engaged
•
UKs 100,000 genome project leading to growth in precision medicine;
• •
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Healthcare delivery systems in 2020 New ideas drive new models 2020 prediction • • • •
The home is where much of the standard TEC care takes place. Specialist hospital treatment is reserved for trauma and emergencies – electives largely day surgery. Many doctor–patient contacts are now virtual informed with real world evidence. New funding models including year of care, pooled budgets capitation, etc.
Today’s evidence •
Home monitoring of patients with LTCs (COPD and Diabetes leading way) – but also home administration of insulin/ warfarin/ chemotherapy
•
PatientKnowsBest ‘patients own their own healthcare information and decide who they share it with
•
ACOs with vertically integrated care and care pathways designed around the patient overcoming silos - In UK new models of care being piloted (FYFV)
•
New provider models /entrants ( Walmart, Apple, Google, Pharma)
•
Hospital to home services
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Wearables and mHealth applications more pervasive and adopted for use in healthcare Everywhere care Affordable apps and wearables can help patients monitor and manage their condition leading to the new clinician/ patient partnerships based on cocreation and a focus on prevention.
Today’s evidence •
mHealth app sector is fastest growing digital health segment with CAGR between 2014 to 2018 of 35% (UK) - 49% globally (£2 - £11 bn).
•
Proliferation of health apps (now over 165,000 2X availability in 2013) and increase in wearables
•
Accuracy and interoperability between devices/ analysis tools still to be addressed
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Low-confidentiality data (wellness and activity) - a consumer-driven purchase largely aimed at primary prevention
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med/high confidentiality data (health data and personal medical records) - used by clinicians, patients or hospital systems
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Around a quarter of consumer apps are now focused on disease medication adherence and treatment management, while two-thirds target fitness and wellness 20
Big Data in 2020 Health data is pervasive new tools supporting new provider models 2020 prediction Healthcare data: •
Attracts significant funding as a national infrastructure priority
•
Is transforming diagnosis and personalised treatment
•
Improves outcomes and productivity
•
Enables new relationships /partnerships between and across healthcare and life sciences
Today’s evidence •
Challenge showing benefits of appropriately used personal health data
• Global genomics market now over $8 billion. Cost of sequencing decreased by 60% in a decade
•
Governments investing in eHealth, IT and health data infrastructure while controlling access and confidentiality (£1 bn over 5 years)
• One-size-fits-all prescribing doesn’t work – precision medicine
•
Clinicians still lack the analytical tools for decision making
• growing use of and potential for predictive analytics
•
Real time data from patients becoming available
• Scarcity of health analytics talent
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How technology and cross industry working are transforming patient care today and tomorrow Healthcare and Life science predictions 2020
How digital technology is transforming patient care today
Disrupting traditional healthcare and life science industries
medtechforum.eu
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Centre for Health Solutions
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In 2015 Smartphone and tablet penetration in UK has continued to increase, fitness bands and smart watches still very low penetration Q. Which, if any, of the following devices do you own or have ready access to? 2013
2014
2015
100% 90%
Penetration rate
80%
79% 76%75%
70%
76% 70% 62%
60%
60% 50%
50%
36%
40% 30%
29%31%31%
20% 10%
1% 1% 2%
2% 4%
0% Laptops
Smartphone
Tablet
eReader
Smart watches
Fitness bands
Source: UK edition, Deloitte Global Mobile Consumer Survey, May-Jun 2013 & May - Jun 2014 Base: All respondents, UK, 2015: 4,000, 2014: 4,000, 2013: 4,020 Deloitte Global Mobile Consumer Survey, 2015
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Bio-sensing wearables Functionality is expanding and use is becoming increasingly unobtrusive Contact lenses that monitor glucose levels
Hearing device to boost hearing
Heart rate monitor patch Smart pills that monitor medication intaking behaviours and body response
Wrist band that monitors heart beat, blood pressure, calories burnt
And now biostamps or tattoos than can monitor temp. sun exposure, pulse, blood oxygen etc. Insole sensor that measures weight bearing, balance and temperature medtechforum.eu
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Importantly sensors don’t admit patients their symptoms do!
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Tackling the barriers to the uptake of digital health In 2014 the European commission launched a stakeholder consultation that identified the following barriers to wider digital health adoption Lack of data protection, privacy, and security standards
Concerns over patient safety, quality and liability and need for a clear legal and regulatory framework Limited cost effectiveness evidence
Lack of interoperability and interoperability standards
Barriers to mHealth adoption
Inadequate funding or reimbursement models
Cultural resistance from healthcare providers
Following stakeholder meeting in July developing industry-led Code of Conduct medtechforum.eu
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Source EC consultation on mHealth Green paper 2014
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Tackling the barriers to the uptake of digital health Patients’ and clinicians acceptance of mHealth apps is dependent mostly on the provision of trustworthy and accurate information, and usability Which of the following would convince you to use health apps regularly? (%) Provide trustworthy, accurate information
69
Be easy to use/ simple/ welldesigned
62
Be free
56
Contain no advertisements
Be packed with detail (I don't mind complex apps)
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N= 1,300, 2014
Is the data really secure?
HCPs
51
Work effectively and consistently over time
Allow me to network with other people important to me
Where’s the evidence for using digital Health solutions?
66
Provide guarantees that my personal data is secure
Not be expensive to buy, and provide value for money
Digital health is unreliable and not appropriate for care delivery
44 28 26
Do my patients have to pay for the technology? What if they can’t?
Whose liable if anything goes wrong with a patient using digital health technology?
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Connected patients: shifting the balance of power Digital technology empowers people to understand and manage their own health and the health of others 75 per cent of the UK population are going online for health information •
This can be an important enabler of self-management for patients with chronic disease and provide vital support for a growing number of carers
•
It is helping shift healthcare delivery, from a traditional paternalistic approach, towards shared ownership
Traditional paternalistic model of care
Empowered patient sharing ownership Health tech
Empowered Doctor
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Empowered Patient
Empowered Doctor
Empowered Patient
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Connected providers: transforming ways of working GP practices have led the way in the move from paper to digital record-keeping but they are still slow to adopt technology in their interface with patients GPs were the first to adopt:
• Digital record keeping • Email consultations
However:
• Text messaging
• Telephone appointments & triage
The full potential for technology to support primary care is widely under-developed
How TEC is benefitting providers Airedale NHS Foundation Trust:
Hospital
• 210 care homes • 113 in discussion
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• Telehealth hub accessed by over 6,000 residents
• 35% reduction in Hospital admissions, A&E use fell by 53%, Hospital bed days decreased by 59%
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Connected providers: transforming home and community care Supporting prevention, early intervention & early discharge from hospital
Home care TEC initiatives can support people with LTCs Supporting care at home – COPD
TEC can support community care staff and improve services to patients Virgin Care – a mobile working solution for nurse community visits Hospital
Wireless blood pressure, weight & pulse monitors
Data stored in patients ‘HomePod’
Data transferred to physician who responds accordingly
Community Nurse
GP
Patient
Used by 150 patients 40% savings compared to ‘usual care’ = £100,000
Patient face-time increased by 29%
26% decrease in GP appointments
nurses were seeing ~ 2 more patients/ day
70% decrease in hospital admissions
60% reduction in paperwork time
86% reduction in local out of hours services
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Connected providers: transforming ways of working Large UK Hospital groups are beginning to make use of digital health solutions to transform ways of working but use elsewhere is not widespread In the UK PDA’s are beginning to replace outdated paper based systems VitalPAC – Northampton General Hospital
EMRs Bedside data recording
Automated alerts if patients health deteriorates
Used by 1500 staff across 28 wards Efficiencies in patient tracking 300% error reduction
The US is leading the way in widespread adoption of hospital digital health solutions • Avera Health: operates seven hospitals and provides a telemedicine service (eCare) to a network of 86 hospitals and over 100 facilities across 600,000 square miles. Estimated saving of $143 million in healthcare costs • Mercy Health: has 33 hospitals in four states. In 2014, its TeleICU solution monitored more than 450 beds in 25 ICUs across the region. Benefits include: a 15-20 per cent reduction in ICU mortality rates, a 10-15 per cent reduction in ICU length of stay, reduced code blues, significant reduction in ICU nurse turnover and improved patient satisfaction.
‘Safer hospitals, safer ward’ technology fund is continuing to drive uptake of digital technologies in hospitals
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http://www.england.nhs.uk/wp-content/uploads/2015/02/success-story-Northampton-0115.pdf 30
http://medcitynews.com/2015/02/five-health-systems-making-best-use-telemedicine
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Connected providers: transforming ways of working Currently healthcare is largely defined by “place” of work digital health services are adopted across the whole health economy this will change •
Accountable care organisations, or vertically integrated organisations are incentivised to deliver care closer to home and reduce more expensive hospital admissions- one of the alternative models being promoted and encourage under the 5YFV Vanguard application process. sensors don’t admit patients their symptoms do! Philips hospital to home:
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Source: Philips Hospital to Home programmes www.http://hospitaltohome.philips.com
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How technology and cross industry working are transforming patient care today and tomorrow
Healthcare and Life science predictions 2020
How digital technology is transforming patient care today
Disrupting traditional healthcare and life science industries
medtechforum.eu
32
Centre for Health Solutions
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Future developments in digital health The rise of TEC is enabling new entrants to better understand customer requirements and enter the provider market as stand-alone providers or partners Solutions that store and integrate health & fitness data Examples include: •
Apple HealthKit
•
Google Fit
•
Microsoft health vault
•
PatientsLikeMe
•
Google are partnering with Novartis, to develop smart contact lenses, which can monitor glucose levels and transmit real time information to a doctor
•
Google are also working on a nanoparticle pill that could identify cancers, heart attacks and other diseases before they become a problem.
Scope to use this technology to allow health providers to receive and transmit data from health check-ups Apple’s launch of ResearchKit in which users decide if they want to participate in a clinical trial and how their data is shared
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Pharma using technology to aid care delivery
Medical Device/ diagnostic technology
•
IBM Watson partnering with Apple, Johnson & Johnson and Medtronic among others to develop a health platform.
•
Pharma among the most active mHealth app publisher; but impact is low – 12 companies have published over 700 apps to educate /assist or monitor treatment compliance
•
Pharma still clarifying ‘best fit’ within the digital health space
•
Opportunities include online repeat prescriptions tele-monitoring compliance live dose adjustment based on real-time monitoring early diagnosis – early 33 prescription
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