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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
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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.
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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
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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.
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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
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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.
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A shared driver for people & society
from reactive
health management
to proactive
health management
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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.
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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
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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
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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
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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.
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(4) Nike Fuel Band: Well being data & tracking
:Share with friends :Compete against friends
Motivation
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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.
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(7) Our devices evolve towards the SoulMate
CPU
SPU
Smart Phone Liferecorder
SoulMate
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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
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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.”
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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
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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
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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.
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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
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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
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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.
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“The patient is the most underused resource in medicine” e-Patient David deBronkart
Tim O’Reilly
A communication gap between healthcare pros and patients
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A potent service design combo
Wearable sensing Minimal personal input
Aggregated meta data presented in motivational
form
Wellness transformation
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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