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8/14/2019 Health 2.0 Coming Soon to a Lab Near You
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Health 2.0?
Coming to a Lab Near You!
Presentation at
Lab Info Tech
Scott Shreeve, MD
Crossover Healthcare
April 10, 2008
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Licensed under the Creative Commons Attribution-Share Alike 2.5 License.
Developed 2006 by Crossover Healthcare with input from numerous public sources.
Presentation
Introduction
1.0 First Generation
2.0 Next Generation Web 2.0
Health 2.0
Lab 2.0
X.0 Into the Future
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Scott Shreeve, MD
Board Certified Emergency Medicine Physician
Co-Founder of Medsphere Systems Corporation First ever enterprise open source electronic health record First commercial implementations of VistA outside of the VA
Helped create/promote concept of Health 2.0 Advisory board member, panelist, author, blogger, speaker
Crossover Healthcare Entrepreneur in Residence Next generation health care finance and delivery
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1.0 First Generation
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Laboratory Testing Market
Market Size 2007
Health Care = $2,200 billion
Diagnostic Services = $ 150 billion
Laboratory Services = $ 45 billion1
Ambulatory Lab Services = $ 12 billion2
Quest = $ 7 billion
Lab Corp = $ 4 billion
Physician Labs = $ 1 billion
1 2007 4Q 10Ks filed by LabCorp and Quest Diagnostics
2 Est from Dark Report Editor in private communication March 15, 2008
http://www.darkreport.com/http://www.darkreport.com/8/14/2019 Health 2.0 Coming Soon to a Lab Near You
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Laboratory Testing Market
Ambulatory Lab Services Market Assumptions1
Lab Corp and Quest = 280M tests
Combined market share = 71.4%
Total Market = 392M tests
~2.5% were paid by patient = ~9.8M tests
Grows to 5% over next 5 yr =~19.6M tests
Average revenue/requisition= ~$35.712
Market size = $700M market
1 2007 4Q 10Ks filed by LabCorp and Quest Diagnostics
2 LabCorp 10K indicates that average rev/req of patient pay = ~$ 158.94
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Laboratory Testing Market
Relative Growth Opportunities
~10% Annual Growth Rate ~20% Annual Growth Rate
06 07 08 09 10Ambulatory Lab Market
475M
450M
425M
400M
375M
06 07 08 09 10Consumer Paid Lab Tests
20M
18M
16M
14M
12M
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WTF?: DTC, DAT, and CDH
CLIA
Federal oversight of accuracy and reliability of laboratory results
Regulates at the laboratory level; not physician or consumer
States
Regulates physician licensure and general commerce
Unwarranted Variation between and within all 50 states
Consumerism
Direct To Consumer (DTC) how most services are marketed
Direct Access Testing (DAT) initiated by patient
Part of the larger Consumer Directed Health (CDH) movement
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2.0 Next Generation
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The World is Changing
If MySpace were a country, it would be the 11th largestin the world behind Mexico. (Techcrunch, 2007)
50% of all healthcare consumed is UGC (Jupiter, 2007)
There are more visits by the same users in a month onDaily Strength than on WebMD
The Machine is Us/ing Us
http://www.youtube.com/watch?v=6gmP4nk0EOE&eurl=http://www.youtube.com/watch?v=6gmP4nk0EOE&eurl=8/14/2019 Health 2.0 Coming Soon to a Lab Near You
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Web 1.0
Hype Cycle
The bursting bubble was part of a natural technical revolution
Shakeout allows ascendant technology to emerge
First Generation Initial content
Static websites
Personal home pages Email and online forums
First electronic transactions
Proprietary business models
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Web 2.0
Gravitational Core Concepts
1. The Web as a Platform
2. Harnessing Collective Intelligence
3. Data is the Next Intel Inside
4. End of the Software Release Cycle
5. Lightweight Programming Models
6. Software Above the Level of a Single Device
7. Rich User Experiences
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Web 2.0
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Health 2.0
First Echos on the Web
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Health 2.0
First Echos on the Web
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Health 2.0
First Echos on the Web
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Health 2.0
First Echos on the Web
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Scott Shreeve, MDMatthew Holt
Dueling Perspectives
Health 2.0 isj ust a term
describing healthcare use of
Web 2.0 t echnology(search,
wikis, blogs, video, online
communities, mash-ups, etc.)
Health 2.0 is a descriptive of a
broader movement toward next
generation healthcare and not just
descriptive of the t echnology
enabling the movement!
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Commonality of Perspectives
1. Transparency
2. Users in control
3. Timely, personal, relevant
information
4. Aggregate, Analyze, Advise
5. Imminent Reform
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The continuum of Health 2.0
Use of Web2.0technologies for
patients and
physicians to
communicate and
investigate withoutconnecting to the
health care systems
Tools andcommunities created
as part of Web2.0 in
health care, then start
becoming connected
to the system (i.e.people use them to
create appointments,
conduct transactions)
Reform in paymentstructures,
transparency, and
technology produces
change in delivery
structure and processaround chronic care
treatment, excellence
centers for particular
procedures, etc.
All the data collectedin a combination of a,
b & c produces leaps
ahead in the process
of care and eventually
in drug and procedurediscovery.
User-
generated
health care
Users connect
to providers
Partnerships
to reform
delivery
Data drives
discovery
San FranciscoSeptember 20, 2007
San DiegoMarch 3-4, 2008
San FranciscoSeptember 2008
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Technology + Reform
= Health 2.0
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Health 2.0: Changing Relationships
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Health 2.0: Changing Relationships
Passive Patients Engaged Consumer Engaged, Educated, and Empowered
Doctor Demigod Physician Advisors Cost/Quality, outcomes focused, and service oriented
Insurance Adversary HealthPlan Advocate Transparent, advocacy, and proactive
System Generated User Generated The Cathedral vs. The Bazaar
The journey is just beginning . . .
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The Transition to Health 2.0Health 1.0 Health 2.0
Zero Sum Competition --> Positive Sum Competition
Opacity --> Transparency
Integration --> Interoperability
Focus on Cost --> Focus on Value
Disease Care --> Health Care
Physician: Ultimate Authority --> Physician: Trusted Advisor
Patient : Passive Observer --> Patient: Engaged Consumer
Pay for Process --> Reward for Result
Culture of Denial --> Culture of Quality
Professional medical information --> Pervasive medical information
The Transi t ion t o Heal t h 2.0.This is a representative, but far from comprehensive, list of the characteristics of Health 2.0
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Health 2.0: Consumer Relationships
New Consumer Interactions with: Medical Providers
Medical Information Medical Search
Medical Finances
Medical Communities
Consumer becomes the central focus Gravitation core of health care interaction
Empowered to use information Accountable for health care status
Engaged in the care process
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Health Care Consumerism
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Personalized Search
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Active PHR Information
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Intelligent Communities
ll
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Intelligent Content
H l h 2 0 C i
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Health 2.0 Companies
Next generation health companies that leverage the
principles of openness, standards, andtransparency; utilize the technology tools of
collaboration, information exchange, and
knowledge transfer; and focuses on deliveringvalue-added services that empower health
participants (patients, physicians, providers, and
payers) with freedom, choice, and accountability
for health outcomes.
H l h 2 0 C i
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Direct access to care
Advisory Services
Collective Intelligence
Mash-up
Network Effect
Health 2.0 Companies
Sermo:
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Sermo:
Online Physician Community
Daily Strength:
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Daily Strength:
Online Health Community
Revolution Health:
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Revolution Health:
Healthcare Consumerism Portal
Vimo:
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Vimo:
Consumer Reports of Healthcare
Yelp:
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p
Community eReviews of Everything
HealthEquity:
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q y
Health and Wealth Advisory Services
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Lab 2.0
Health 2 0 in the Lab
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Health 2.0 in the Lab
Expanding Access to Laboratory Information Testing
Analytic Proteomic Genetic
Analytics Treatment triggers off of lab values
Reporting Education
Counseling Value added advisory services
Health 2 0: Genetic Testing
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Health 2.0: Genetic Testing
Protein blueprints with disease potential Recreational Genetics clinical implications?
Heavily regulated and highly political (GINA)
Health 2 0: Proteomic Testing
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Health 2.0: Proteomic Testing
Active proteins causing disease Breast, Ovarian, Prostate, etc
Consumers want access to these tests
Health 2 0: Analytic Testing
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Health 2.0: Analytic Testing
Basic body chemistry as a result of disease The foundation of diagnosis and relevant clinical information
In many ways considered the largest opportunity ($700M)
Health 2 0: Lab Analytics
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Health 2.0: Lab Analytics
Lab Testing information as therapeutic platform Electronically captured / stored information in PHR
Mined by analytic engines to create personalized messaging
Example: HealthEquity Elevated A1C triggers proactive response Creates opportunity for company to demonstrate value,
increase compliance, reduce costs, and improve health
Health 2 0: Lab Reporting
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Health 2.0: Lab Reporting
Reduce Complexity and Increase Understanding Utilize new media to help consumers more readily interpret
Create customized, professional report electronically
Example: Biophysical
Detailed report in easy to interpret graphical style
Health 2 0: Lab Counseling
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Health 2.0: Lab Counseling
Basic body chemistry as a result of disease The foundation of diagnosis and relevant clinical information
In many ways considered the largest opportunity ($700M)
Example: DNA Direct Realized that genetic testing would be commoditized
Built out a nation wide network of genetic counselors Their competitive differentiator is ability to effectively
advise consumers on clinical relevance of genetic testing
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DAT in Detail
Lab 2 0: DAT Overview
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Lab 2.0: DAT Overview
Lab 2 0: DAT Portal
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Lab 2.0: DAT Portal
Lab 2 0: DAT Process
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Lab 2.0: DAT Process
Lab 2 0: Account Creation
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Lab 2.0: Account Creation
Lab 2.0: DAT Orders
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Lab 2.0: DAT Orders
Lab 2.0: CA Protocol
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Lab 2.0: CA Protocol
Lab 2.0: DAT Transaction
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Lab 2.0: DAT Transaction
Lab 2.0: DAT DLO
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Lab 2.0: DAT DLO
Lab 2.0: Physician Oversight
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Lab 2.0: Physician Oversight
Lab 2.0: Results Release
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ab .0: esults elease
Lab 2.0: Personal Health Record
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Conclusion
Conclusion
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Web 2.0 is the evolving tools, technologies, andthemes of the post-bubble internet renaissance
Health 2.0 defines an emerging healthcaredelivery model of enabling technologies and the value-based reform initiative
Lab 2.0 will increasingly engage consumers byproviding comprehensive testing, improved analytics,enhanced reportingand value-add counselingservices
For more information
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CONTACT:
Scott Shreeve, MDCrossover Healthcare
ATTEND:
Consumer Health WorldMay 4-6, 2008Las Vegas, NV
www.consumerhealthworld.com
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Value Driven Health Care
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Technology + Reform = Health 2.0
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