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Applying ICT & Innovation for the Aged –
Enabling better health and enhanced participation to create economic and
societal multiplier effects
Dr Mehdi Khaled | Chief Medical Officer, Oracle Corporation Tokyo, 12th September 2012
Page 2
Non-Communicable Diseases are Prevalent in
Mature Economies
Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
0
100
200
300
400
500
600
700
800
Low income Lower middle income Upper middle income High income
Communicable Non-communicable
Source: Sheehan P. & Al; The return to investment in health innovations
Global age-adjusted mortality rates by region and cause, 2008 (deaths per 100,000 population)
Incidence of Chronic Disease is growing, as is
the complexity, as the population ages!
Prevalence of chronic illnesses in the Basque Country, Spain
% of patients by age and # of chronic illnesses
1 Illness
2 Illnesses
3 Illnesses
4 Illnesses
5 Illnesses
+6 Illnesses
Courtesy of
Page 4 Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
This calls for an imminent need for innovative
healthcare interventions and related technologies…
Source: PwC, Jan 2011.
Page 5
Defining Healthcare Technology
Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
Medical instruments, devices, and equipment, including medical
diagnostic machines (X-ray, CT scan, MRI); medical therapeutic
devices (drug delivery, surgical instruments, pacemakers, artificial
organs); and other health-related products, such as medical
monitoring equipment, handicap aids, reading glasses, and contact
lenses. Medical technology also includes molecular diagnostic
devices and health information technology, such as smart phone
and IT applications.
This broad range of products goes from simple, noninvasive
equipment, such as wheelchairs, to high-tech and highly regulated
invasive devices, such as pacemakers and insulin pumps.
Source: PwC, Jan 2011.
Page 6
Applying Healthcare Technology
Innovations needs to be structured…
Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
Source: Oracle Analysis
Instruments
Devices
Equipment
Health Information Technology
Applications*
Diagnostic
Therapeutic
Monitoring
Noninvasive
Invasive
What? Why? How?
Clear Indications Measurable Benefits Regulations Who pays?
* Mostly not regulated
Page 7 Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
Startrek Tricorder
Tele-monitoring
Page 8 Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
Challenge #1
Benefit claims are not always proven
Source: Arch Intern Med. Published online April 16, 2012.
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Source: Basu S, Hassenplug JC. N Engl J Med 2012;367:485-488.
Comparison of Time to Market in Premarket Approval and Reimbursement Processes
Challenge #2
Market entry is defined by reimbursement decisions
and not first adopters
Source: Basu S, Hassenplug JC. N Engl J Med 2012;367:485-488.
Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
Comparison of Time to Market Access for Five Innovative Devices in France, Italy, and the United States.
Challenge #3 Market access to same technology varies widely between countries
In aging societies, different sub-groups
have different needs
1 Illness
2 Illnesses
3 Illnesses
4 Illnesses
5 Illnesses
+6 Illnesses
Courtesy of
<70 70-80 >80
‘Preventive’
Stay Active, Independent,
Delay complications
‘Curative’
Adherence to
interventions
‘Palliative’
And long term interventions must
aim at delaying and flattening this burden
Source: Reuben DB, Tinetti ME. N Engl J Med 2012; 366:777-779
Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
A Realistic Opportunity From disease-specific to goal-oriented outcomes
Achieving the multiplier effect in aging
societies: practical thoughts
Invest in disruptive healthcare innovation and enforce IP protection
policies
There’s no one-size-fits-all approach: Define age groups and goals
Enhance x-geography collaboration to assess the impact of technology
use in each age group
Harmonize policies and processes for faster reimbursement in close
OECD an APEC economies to drive wider adoption
Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
The 21st Century Tricorder
http://www.youtube.com/watch?v=PRgJGAot83c
Copyright © 2012, Oracle and/or its affiliates. All rights reserved.