Answering Healthcare Needs through Technologybaconvention.com/.../12/11....Praveen-S-Deloitte.pdf©...
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© 2014 BA Convention
Answering Healthcare Needs through
Technology
India Market Focused
Praveen Sankaranarayanan Deloitte
© 2014 BA Convention 2
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Agenda
Healthcare Industry Overview – Players in the Market
Industry trends and Challenges
Key takeaways
Lessons from other industries to achieve Patient Centricity in Healthcare
Managing Stakeholders in Healthcare Ecosystem through Collaboration
Fixing an unsatisfactory equilibrium in Healthcare using IT
Summary
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Understanding the Stakeholders in the Healthcare industry
Healthcare Industry Overview
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Industry customers and participants
Other Industry Participants
Health Plans
Providers
Biotech &
Pharma
Not for Profit
Organizations
Governments
Medical Devices
Customers for the Healthcare Industry
Patients
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The Healthcare systems of the world
Systems in which the national government owns,
operates and pays for the entire health care system.
– UK, Spain, Hong Kong, New Zealand
The government does not provide health care directly.
Instead, the government controls one or more national
health insurance plans that reimburse private health
care providers.
– Medicare of US
Individuals and their dependents receive health
insurance through health insurance plans provided
through their employer
– Germany
Not all countries offer universal coverage to their citizens
or residents. Residents in these countries can purchase
individual health insurance to cover some of their health
care costs.
Healthcare Systems
Socialized health care systems
National health insurance systems
Employer-sponsored health insurance
Individual responsibility
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Trends in the Indian Healthcare Industry
WHO has officially certified India as a Polio free nation
CIGNA TTK health insurance carrier’s entry
through promotion of Wellness programs
Aging population and increasing life expectancy drives demand
Health care professional shortage limits supply
Medical Tourism on the rise
Increase in incidence of lifestyle-related diseases
Growth in single specialty hospitals
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Changing Outlook of Providers in India
Sponsorships to perform free heart surgeries for poor children
Heart treatment camp for the poor and the needy at highly subsidized costs
Camp for arthritis patients providing X-Ray and other tests at discounted rate
Reach out to the lower income strata via 60 "tele-medicine" centers
Apollo Group
Hospitals
Lilavati Hospital Has a social service department called SEWA
– Free medical and surgical services including CABG, Valve replacement, Cancer and Orthopedic surgery
– Free OPD for 2 hours daily
– For senior citizens, hospital vans for examining BP and Sugar levels and giving free medical advice
– Mobile clinic providing free treatment to the slum areas in Mumbai. Group sessions like "Malaria Prevention and
Treatment", "Cancer Awareness", "Child Health Care“, etc are also held in these areas
Source: Hospital Websites, Press Articles
Corporate Social Responsibility Program
– Set up Primary Health centres offering free consultations, medicines and a 50% discount on diagnostics
Community Outreach Program
– Delivers heart & vascular care treatment to the unprivileged and educates community doctors
Max Healthcare
For-profit mindset supports the idea of making money…while still tending appropriately to
the needs of the lower strata who are at the bottom of the Pyramid
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Increasing growth of Payers in Indian Market
Source: Industry Discussions, Secondary Research
Higher Quality, Appropriately Priced Insurance
Products and new Disease-Specific Products
To..
Improved quality of insurance products/ offers
– Coverage beyond hospitalization to cover
OPD drugs, tests and treatment and flexible
(and even no) caps on cover limit
– More customized options
Insurers price and manage Group health
insurance products profitably
Health insurance providers open to discussing
new product options (disease-specific or
otherwise)
Emerging disease-specific products
From…
Limitations on coverage and typically have
caps on cover limit (~US$ 3500)
Limited options of insurance products
Unprofitable Group health insurance
products
Regulatory and Competitive Evolution in Health
Insurance Sector
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Role of Government in Indian Healthcare
Market
National Health Programs
National Cancer Control Program (NCCP) aims at prevention of tobacco related cancer; early detection of cancer;
augmentation of treatment facilities;
Universal Health Insurance scheme
Note: 1Program for Appropriate Technology in Health
Source: Secondary Research, Central and State Government Sites, Press Articles
Maharashtra
Specific focus on HIV/ AIDS and
Women’s health
Andhra Pradesh
Financial support for Hepatitis B
Model Immunization System for
Hepatitis B, a project in
partnership with PATH’s1 Children
Vaccine Program
Karnataka
Primary focus on Cancer and
Women-Child health
Karnataka Cancer Society provides
weekly free checkups
Research centre for cancer
genomics
Increased funding for patient
awareness, diagnosis and treatment
Kerala
Primary focus on Hepatitis B and
maternity care
Delhi
Primary focus on HIV/ AIDS and
water-borne diseases
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Lessons from Other Industries in the US
Operational Synergies- Perspectives of a
Winning Approach to achieve Patient Centricity
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Industry Supply Disruption in the US towards Consumerism
Reg
ula
tion
Economics
Te
ch
no
log
y
New intermediaries(Fidelity, Sears)
Product Innovation – Mutual Funds
Trends
Electronic
funds transfer
ATM
High Inflation Rates
Low returns on savings accounts
Shift of funds from traditional deposits
Deregulation Financial Services – 1980’s
Reg
ula
tion
Economics
Tech
no
log
y
New intermediaries(einsurance.com)
Product Innovation – HSA, HRA
Trends
Pharma
breakthrough
Internet,
ecommerce
Cost of healthcare increases
Employers shift cost burden
Increase in uninsured
PPACA
HiTech Healthcare –
2009-10
Telecommunications Act of 1996
Financial Services – 1990’s Healthcare – Late 2000’s
Airline Deregulation Act of 1978
Financial Services Modernization Act of 1999
National Energy Policy Act of 1992
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Connecting the dots for Solutions and Outcomes
Fixing an unsatisfactory equilibrium in
Healthcare using IT
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IT as an enabler in the Changing External Environment
CRM Collaboration
Analytics
Social Media
Channel Management
Portals, Content
management
Enabling Consumerism in
Healthcare
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Key Note
Breaking down barriers in Healthcare
Ecosystem through Collaboration
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Vision of Partnership /Collaboration between Provider and Pharma
The Collaboration Imperative
• Pursue rapid growth as health reform, and managed care expansion opportunities unfold
• Leverage best practices from two industries to create a framework for achieving greater scale and efficiencies
• Strengthen positioning and brand in the Healthcare market
• Sustain and strengthen value proposition for communities, and members
• Understand cultural similarities and differences to manage transitions, ease ƒanxiety, and minimize disruption
• Both hospitals and manufacturers have incentive to increase access to medications with improved outcomes
• Health care Providers provide patients with access to medications while manufacturers can vouch for the positive outcomes of their medications
Reduced
Healthcare Costs
Improved Patient
Satisfaction
Opportunities Principal Focus Areas
Considerations
Improved Patient
Outcomes
© 2014 BA Convention 16
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Vision of Partnership /Collaboration between Payer and Pharma
The Collaboration Imperative
Entry Point Offerings Evolved Offerings End State
Partnerships
End-to-End Patient
Centric Partner
Member Analytics and Diagnostics
Claims analytics
Care Analytics
Disease Management
Channel and Sales Analytics
Integrated Care Management
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Summary
• Healthcare industry investment in technology lags behind that in other industries, but it will
begin to catch up soon !!!!
• Investments in Big Data and analytics can leapfrog the industry to improve the accuracy of
decision making at the point of care and to provide additional insights for clinical and
operational research.
A little foresight goes a long way!!
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