Digital transformation in Healthcare: Disruption or ... 2017/Yvon_Digital... · Global Shifts Drive Momentum: innovation drivers Dynamic Delivery 50% Expected alternative payments

Digital transformation in Healthcare:

Disruption or innovation?

2 © Copyright IBM Corporation 2017

Human Centric Innovation Center | Europe

Marc YVON

Human Centric Innovation Center Director Master Inventor

Member of the IBM Academy of Technology

@MarcYvonIBM



Credit to PureReinvention



Chronic diseases

represent significant

avoidable expense

$47 Trillionin estimated cumulative global economic impact due to chronic disease¹

75%+Percentage of patients expected to use digital health services in the future³

New technologies are

changing how individuals

engage and interact

50%of traditional Medicare payments tied to quality or value through alternative payment models by the end of 2018²

Payment is shifting

to reward value

and quality

• Where and how care is delivered

• How care is financed

• The role of the individual

----are all changing.

The healthcare industry is changing dramatically—creating more complexity and uncertainty, yet great opportunity

SOURCES: 1) http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf; 2) January 26, 2015 HHS press release: Better, Smarter, Healthier;

3) http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future



20202010200019901980

Digitalization Integration Cognitive



Augmented Intelligence / Cognitive in Health: Over a Decade in Development

2005 2010 2012 2014 20152008 2011 20162014

Cognitive test

case results

in creation of

Watson

IBM enables an

“evidence-based

Healthcare

eco-system”Memorial Sloan

Kettering Cancer

Center

Cleveland Clinic

Mayo Clinic

7,000 employees

10,000+ clients & partners



Global Shifts Drive Momentum: innovation drivers

Dynamic

Delivery

50%Expected alternative payments

from Centers of Medicare &

Medicaid by 20184

75%+of patients expected to use

digital health services5

60-90KExpected shortage of

physicians by 20256

$47 trillionEstimated global economic

impact of chronic disease by

20307

100’sNumber of decisions a

person with Type 1 Diabetes

makes a day9

$3 trillion Estimated U.S. healthcare

spending8

150+ exabytesof healthcare

data today1

Over 230Kactive clinical trials2

80% of healthcare data coming from

unstructured sources3

< 10%drugs currently in development

that make it to market12

$2BAverage costs to develop a new

pharma drug11

1 in 10clinical Trials in cancer

are shut down from lack of

participation10

Data

Explosion

Efficient, Effective

R&D

Value vs

Volume

Sources: 1: NCBI. Big data analytics in healthcare: promise and potential https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341817/ 2: ClincalTrials.gov https://clinicaltrials.gov/ 3: NIH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127205/ 4:CMS https://innovation.cms.gov/initiatives/Health-Care-Payment-Learning-and-Action-Network/ 5: McKinsey Healthcare’s Digital Future July 2014 http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future 6: AAMC Report The Complexities of Physician Supply and Demand: Projections from 2014 to 2025 https://www.aamc.org/download/458082/data/2016_complexities_of_supply_and_demand_projections.pdf 7: WEF Global Economic Burden Non-Communicable Diseases http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf 8: CMS, Team analysis https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf 9: OpenAps.org https://openaps.org/2015/02/04/introducing-the-openaps-project/ 10: Bio- Clinical Development Success Rates 2006-2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843106/ 11:Bipartisan Policy Center https://cdn.bipartisanpolicy.org/wp-content/uploads/2016/06/BPC-Health-Innovation-Safe-Effective-Cures.pdf 12: Bio- Clinical Development Success Rates 2006-2015 https://www.bio.org/sites/default/files/Clinical%20Development%20Success%20Rates%202006-2015%20-%20BIO,%20Biomedtracker,%20Amplion%202016.pdf

http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future

https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf

https://cdn.bipartisanpolicy.org/wp-content/uploads/2016/06/BPC-Health-Innovation-Safe-Effective-Cures.pdf





Innovation Differentiated Components

Cloud Content Cognitive

Computing

Collaboration



We are on a complex journey

Risk Capable

Fee-for-service peak

– Reduced ER visits

– Reduced re-admissions

– Reduced admissions

– Reduced specialty visits

Value-based care peak

– Care coordination/Patient engagement

– Electronic Medical Record/Central Data Repository

– Grow marketshare

– Improve margin

– Patient Care Medical Home/Primary Care Physician

engagement

Declining

Reimbursements

Revenue

control



2016 2030

7:1 4:1The ratio of availablecaregivers between 45 and 64 to care for people of 80+ old

Due to demographicshifts this ratio drops dramatically triggeringa need for new approaches to care giving includingproactive services and prevention-driven self-care tools



Engage Consumers

- Patient engagement and education

- Employee engagement

- Workforce health management

- Patient/Member outreach

- Price transparency

- Optimize care utilization

Engage in new ways with individuals, care teams and across your enterprise



Disruption for Patient: Personalization Care



Cognitive / Artificial Intelligence is Key for Disruption

Understand

Watson can

read and understand

documents and data–

both structured and

unstructured –

at a massive scale.

Reason

Watson searches and

analyzes data,

returning evidence-

based options.

Learn

Decisions made by

leading experts feed the

engine. Watson learns

and improves over time.

Cognitive



Use cases



1. Visual Care

People with impairments or bedridden are not able to move from one side to another in their bed because of lack of energy, paralysis or pain.

When at hospital or homecare, nurses have to change the patient body position so that they don’t get more pain (with skin lesions for example).

Problem statement



1. Visual Care

Objective

Regularly check if the person has been moved/changed his body position within the contractual agreed time between the institutions and their patients.

To do so we used a thermal camera and IBM Visual Recognition (IBM Watson service)



1. Visual Care

Proposed solution Learning (prerequisite)

• Use thermal camera to get body energy in the bed• Feed a dedicated machine learning with pictures

Multi-class classifications: Left, Front and Right

Position change detection • Take pictures at defined time intervals (tbd)• Confront to machine learning and get position • Decide if position changed (from last position change)

Analytics • Real time: alerts on watch/dashboard : if interval

between actual time and previous time exceeds criteria (tbd)

• Historical: reporting per patient or per caregiver or …



1. Visual Care

Solution benefits• Patient is not ”forgotten” and is eased

from any body position pain

• Real time alerts on watch/dashboard: if interval between actual time and previous time exceeds criteria (tbd)

• Historical: reporting per patient or per caregiver or …



2. Neurological Care / IoT - Dialogue

Objectives / Problem Statement

• Find a solution that enable people with psychomotor functioning impairment (injury, dementia, etc…) to participate more fully in their lives.

• Provide customized support that match abilities and help to learn and complete movements or activities of daily living



Proposed solution

Leverage Watson Technology and statistical model to:

• Interpret movement from connected object (ball)

• Get factual evolution data

• Adapt interactions and dialogs

• Learn new movements


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Solution benefits• Child with autistic syndrome is doing

actions within a “game” and not as a consequence of an adult order

• The tool as a ball is seen like a toy but it helps not only the child but also parents and therapists

• Watson technology helps therapists to better understand if the child is doing well what the ball asks him




3. Rehabilitation / IoT

Objectives / Problem Statement

• Practitioners are Lumbar Belt prescribers. At the same time they also ask for physiotherapy or other physical alternatives.

• Lumbar belt are free for patients.

• Objective is to encourage doctors to prescribe lumbar belts.




Proposed solution

In order to reach this aim customer wants physiotherapist and medical personnel to be actors in prescribing exercises to their patients in a declarative or monitored way.




Solution benefits

• Patient can exercise and know that their physiotherapist is aware of their progress

• Physiotherapists may check and monitor improvement or failure thus be more involved into patient care



4. Cognitive Care / Dialogue

Objectives

• Let hospital, retirement home or nursing home teamcreate their own cognitive application dialoging with their patients.

• Provide them a flexible solution which takes connected objects, video and voice interaction into account.

• Record evolution of patient behavior



4. Cognitive Care / Dialogue

Proposed solution• An intuitive interface for health teams to

create/update dialog structures dedicated to patient application

• Hide technology behind, with simple buttons to upload models into Watson Conversation, to connect IOT and record videos

• A simple application dialoging with the patient according to the administrator conversational model and using Watson APIs (speech to text, text to speech, conversation, IOT foundation)



4. Cognitive care / Dialogue

Solution benefits• Healthcare personnel manages application

for their patient

• Application are dedicated to personalized patient difficulties

• Patients could be monitored remotely

• Patients’ difficulties can be compared personally or within a group of patients



5. CaféWell / Health reward program

Challenges

• How to keep on with good resolutions?

• People want to feel well: how technology can help them?

• And if they could be rewarded for doing well …




Solution

• Learn who you are, make recommendations

• Easy to use on multi-devices application

• Within a private, secure environment

• Powered by IBM Watson




Solution benefits

• Help people taking care of their health

• Keep track of person’s progress

• Give a reward when actions performed on: food, exercises, …



BALANCE NUTRITION

HYGIENE

MEMORYFEELINGS

SOCIAL

Knowledge & insights for dependent people over a life time

Explosion of connected objects wearables or multiple connected devices allow measuring & monitoring criteria of dependent people.

Aging / Evolutive Autonomy



Credit to PureReinvention

hvala | merci | thank you | gracias | danke | grazie