: : The Future of Healthcare? W H A T D O E S T H E F U T U R E H O L D? The Empowered Consumer Dr. Anne Anne W. Snowdon, W. Snowdon, RN, BScN, Chair MSc, PhD World Health Innovation Network, Odette School of Business World Health Innovation Network, Odette School of Business @WIN_Health World Health Innovation Network
G L O B A L C O N T E X T I N 2 0 1 3 Rising Global Healthcare Costs: 5.3% per year (2014-2017) 17.4% 8% 10.7% 6.4% 6.6% Highest global spending as a percentage of GDP is in North America Deloitte, 2014
C A N A D I A N C O N T E X T I N 2 0 1 3 Total Spend: $215 Billion Economy: 11% of GDP Growth: 5.5% (2011) CIHI, 2014
O V E R A L L P E R F O R M A N C E R A N K I N G A U S C A N F R A G E R N E T H NZ N O R S W E S W I Z UK U S A O V E R A L L R A N K I N G ( 2 0 1 3 ) 4 10 9 5 5 7 7 3 2 1 11 Q U A L I T Y C A R E 2 9 8 7 5 4 11 10 3 1 5 E F F E C T I V E C A R E 4 7 9 6 5 2 11 10 8 1 3 S A F E C A R E 3 10 2 6 7 9 11 5 4 1 7 C O O R D I N A T E D C A R E D 4 8 9 10 5 2 7 11 3 1 6 P A T I E N T - C E N T R E D C A R E 5 8 10 7 3 6 11 9 2 1 4 A C C E S S 8 9 11 2 4 7 6 4 2 1 9 C O S T - R E L A T E D P R O B L E M 9 5 10 4 8 6 3 1 7 1 11 T I M E L I N E S S O F C A R E 6 11 10 4 2 7 8 9 1 3 5 E F F I C I E N C Y 4 10 8 9 7 3 4 2 6 1 11 E Q U I T Y 5 9 7 4 8 10 6 1 2 2 11 H E A L T H Y L I V E S 4 8 1 7 5 9 6 2 3 10 11 H E A L T H E X P E N D I T U R E S / C A P I T A, 2 0 1 3 * $ 5, 8 2 7 $ 5, 7 1 8 $ 4, 8 6 4 $ 5, 0 0 6 $ 6, 1 4 5 $ 4, 0 6 3 $ 9, 7 1 5 $ 5, 6 8 0 $ 9, 2 7 6 $ 3, 5 9 8 $ 9, 1 4 6 T O P 2 M I D D L E B O T T O M 2 Commonwealth Fund, 2014; *World Bank, 2014
W H E R E A R E H E A L T H S Y S T E M S G O I N G? G L O B A L T R E N D S Empowered Consumer Shift Towards Wellness Emergence of Digital Tools Single illness to Multi-comorbidities Accountability and Value
S H I F T I N G T H E H E A L T H S Y S T E M P A R A D I G M T H E E M P O W E R E D C O N S U M E R
The Digital World: Canadians spend approximately 45 hours per month online and 7 days a year on Facebook CIRA, 2013; Gov. Can., 2010
. In Canada, 56% of people have a smartphone and 79% say they would not leave home without it Canadians check their smartphones 127 times per day Deloitte, 2014; CBC, 2014
In 2012, 44 million unique healthcare apps downloaded Searching for health information is now the thi rd most popular online activity for all internet user s 18 and older. There are over 97,000 health applications Deloitte, 2014
Global Revenues of seniors download apps, fastest growing market, 39 71% million using social media Mobile Healthcare Application Market: $26 Billion in revenue by 2017 360% Deloitte, 2014; CBC 2014
Our society increasingly relies on transparent, real time information at a glance, from everywhere E.g. Uber, FedEx, etc.
Consumers are creating their own personal health systems, not connected to the formalized health system E.g. Fitbit, MapMyRun
Health System Challenges in Connecting to the Consumer World? Healthcare information is provider centric, not easily accessible to patients, no flow of information across the continuum of care
SHIFTING CONSUMER CULTURE MY CHILDREN Impatient Super Connected MY PARENTS Patient, used to waiting Values Stable relationship Loyalty to Value Health as a Right Researches, asks for data, negotiates Loyalty to Brand Health as a service Defers to the expertise of the provider
Consumers who will Transform Health Care: Women and Baby Boomers 94% of Women make majority of health decisions for their families -Chief Medical Officer for the family 7 million women in Canada provide care for both children and aging parents Boomers: wealthy (47x net worth), 3 Central Values: 1. agelessness, 2. autonomy, and 3. personalization
Age-Adjusted Prevalence (%) Chronic disease rates increasing 0.8 14% per year 0.6 0.4 0.2 0 2001 2010 2020 2030 2039 Cancer Cardiovascular Diseases Diabetes Hypertension
FUTURE OF H E A L T H S Y S T E M S? N E E D T O mg E T C O N N E C T E D A N D A C H I E V E V A L U E F O R C O N S U M E R S We use digital technologies every day to to shop, study, do banking, travel. except for health care Facebook connected people to the world around them, health systems need to do the same E.g. Bluetooth Pacemaker
Priority Populations: Youth 12-25 yrs. 5 0 % O F A D U L T M E N T A L H E A L T H S T A R T S B E F O R E A G E 1 4 Y R S.
S M A R T M E N T A L H E A L T H : The idea that I can have my individualized mental health care and health care team in my pocket... Walking with me, at my fingertips... Rahma
REDEFINING HEALTH CARE: SHIFT TOWARDS PATIENT & FAMILY GOALS Wellness, Prevention, Quality of Life Empowered Consumers want the flexibility to determine what they need most, disease management is just not enough. Ex. Knee replacement
The Challenge of Complexity: Meet Jim: COPD, Stroke, 24 medications, 8 providers visiting weekly, 8 admissions to hospital in last 14 weeks, multiple ED visits & Wife struggling to cope It is no longer "One Size Fits All", Families assuming increasing caregiver burden need the flexibility to tailor their care plan to their unique and evolving situation
Chronic Illness Management: Navigating the Impossible
C O M P L E X I T Y O F M U L T I - C O M O R B I D I T Y P A T I E N T S R E Q U I R E I N T E G R A T E D, T R A N S P A R E N T C O L L A B O R A T I VE C A R E Improve Transparency between primary care providers, hospital and community care providers who hold each other accountable for executing the plan to achieve outcomes. E.g MediaMed
O N E - S I Z E F I T S A L L T O O N E - S I Z E F I T S O N E Personalization in product development and service delivery is the future which is emerging rapidly IT solutions that connect consumers to providers will be important for transparency and connectivity across the continuum of care Trato
Shifting Accountability that "levels the playing field" Shift away from a provider knows best to Collaborative partnership between providers and patients
D E M O C R A T I Z E I N F O R M A T I O N : P U T H E A L T H I N F O R M A T I O N I N T O T H E H A N D S O F C O N S U M E R S, J U S T L I K E E V E R Y O T H E R S E C T O R Transparency Real Time It is easier to open a Swiss Bank Vault than to access your personal health information! People need health information to make informed decisions with their providers, and flow seamlessly across the continuum of care
P U T T H E P O P U L A T I O N I N C H A R G E O F D E F I N I N G V A L U E : T H E Y W I L L A N Y W A Y! How many stars would you give this resort? -Trip Advisor
M E A S U R E W H A T M A T T E R S : B R I D G E T H E D I S C O N N E C T B E T W E E N T H E S Y S T E M A N D T H E C O N S U M E R Consumers measure progress towards their healthgoals Health Systems Measure: Survival (Mortality rate), Infections, Readmissions, Adverse Events, etc.
Create Transparency: Streamlined, Efficient, Accessible Health Information "You know everything you need to know in "Real Time"
F R O M T R I P L E A I M T O T R I P L E V A L U E Convenience Value Choice Cost System Focused Consumer Focused
Leading the Future of Health Care? If I had asked people what they wanted, they would have said faster horses
B U I L D T H E E V I D E N C E F O R I N N O V A T I O N A D O P T I O N A N D S C A L A B I L I T Y Research Innovation New technology New therapies Proof of Concept Clinical Innovation Patient care implementation Clinician adoption Integration into service delivery Proof of Relevance Innovation Adoption across Health Systems IT decision support Service delivery model redesign Performance metrics support adoption Financial model for reimbursement Leadership to drive innovation Clinical guidelines Integration Consumer uptake Proof of Value and Reimbursement
F U T U R E O F H E A L T H C A R E : : : C O N S U M E R P E R S O N A L I Z E D C O N N E C T E D T O P E O P L E S D A I L Y L I F E C O N S U M E R D R I V E N - V A L U E S E L F M A N A G E M E N T W I T H P R O V I D E R A S P A R T N E R C O L L A B O R A T I V E I N T E G R A T E D T E A M S O U T C O M E S D R I V E N
Nobody s going for us, but, making use of technological and human alike, we might just be able to. Jamais Cascio
Thank you. snowdon@uwindsor.ca @WIN_Health
Challenges All Countries are Facing: T R A N S A C T I O N A L S Y S T E M S W I T H L I T T L E I M P A C T O N P O P U L A T I O N H E A L T H P R O V I D E R A N D S Y S T E M F O C U S E D - N O T R A C E A B I L I T Y, P O O R S A F E T Y U N S U S T A I N A B L E C O S T S A N D G R O W I N G D E M A N D S D I S C O N N E C T E D F R O M T H E C O N S U M E R M E A S U R E T H E S Y S T E M N O T V A L U E F O R P O P U L A T I O N S