John Crawford, IBM

© 2012 IBM Corporation

IBM Healthcare & Life Sciences

John Crawford, Healthcare Industry Leader, Europe

© 2012 IBM Corporation2

IBM’s involvement in Healthcare Buyer of healthcare services in the US

– 450,000 lives; $1.5B in investment – Partner to promote innovation and value

Change agent – Founder of Patient-Centred Primary Care Collaborative– Healthcare standards - IHE, HL7, Continua etc.– National level reform and eHealth – IBM Research and whole systems thinking– Over 600 patents

Solution provider across the continuum– Payers / Providers / Life Sciences / Medical Devices– Infrastructure build and optimization– Safe and secure transaction processing– Big Data, information management and analytics– Horizontal systems integration– Solutions that intersect business and technology


Industry challenges

and opportunities

Healthcare system transformation is full swing

Critical resource shortages

Increased competition and new entrants

Advances in technologies and treatments

Escalating incidence and cost of chronic disease

Globalization of health care

Changing demographics and lifestyles

Expectations for better quality, outcomes and value

Source: IBM HCLS, IBM GBS Institute for Business Value


Current business models within healthcare are derived froma historical approach to providing medical care

Core Principles of Current System

• Over-emphasis on expensive treatments and incremental improvement

• Myopic focus on capacity for acute care

• Use of volume-based reimbursement models

• Patients are responsible for coordinating their own care

• Care varies by venue and clinician

• Quality is determined by the provider

Tomorrow’s Healthcare System

• Focus is on value, coordinated around the patient and integrated into communities

• Emphasis is on proactive care to meet health needs

• Payment is based upon value and outcomes

• Care is standardized according to evidence-based guidelines

• We measure quality and make rapid changes to improve it

• Knowledge is translated into practice


To redefine value and success in healthcare, we need to build sustainable, collaborative and equitable services

EVIDENCE AND PATIENT CENTRIC HEALTHCARE

COLLABORATE TO IMPROVE CARE AND OUTCOMESImprove the quality and efficiency of care, engaging the service user to personalise their healthcare experience, based on their preferences

BUILD SUSTAINABLE HEALTHCARE SYSTEMS

Build an efficient, flexible system that proactively

manages cost and regulatory requirements,

and enables greater transparency and

accountability.

INCREASE ACCESS TO HEALTHCAREReduce disparities in access and influence

individuals to become advocates for their own health.


Our payer and provider clients are adopting five emerging care models

Acuteepisodic

Complex chronic

Healthy,at-risk

Earlychronic

20+ PCPs(20% of total)

PCMH

Incr

easi

ng p

rovi

der i

nteg

ratio

n

Increasing clinical risk and severity

Accountable careorganizations5

Pro-active primary care provision2 Sp

ecia

lity

care

mod

el1

3

Epis

odes

of c

are

4

Clinical service factories1

Source: McKinsey Center for U.S. Health System Reform

Evolution of Care Delivery

Convergence of Payer and Provider

Movement to the Individual


Service users are empowered and expect flawless interactions with health service care providers

““Listen to me”Listen to me”

““Know me”Know me”

““Serve me”Serve me” Personalizeofferings

Personalizeexperience

Personalize services

More than halfof “connected” service users state internet and social media interactions influence decisions Top area for

health system innovation – self service, convenience and ease of access


Redefining value requires new competencies

Collaboration and partnering

Information proficiency

Personalization of health

Talent creation and retention

Technology enablement

Industry Imperatives


Improved Outcomes

Evidence + Incentives

THESIS: The industry is moving towards evidence-based medicine, change management and informed policy making to drive healthcare transformation and yield lower costs and improved outcomes

Our vision and commitment for IT-enabled change

EvidenceGeneration

EvidenceDelivery

Coordinated care and

Incentives

The Vision (IBM Approach)


Sustainability

Quality

We apply our systems and solution focus to help reform healthcare systems and transform healthcare providers

Health and Economic Value Outcom

es

Dynamic Infrastructure

Structured and Unstructured Data Generation and Aggregation

Compliance, Resilience, Privacy, and Security

Retrospective Reporting to

Predictive Analytics

PersonalizedHealthcare

Value

Integration /Interoperability

Collaboration and Automation

Health Integration Framework

Access


ibm.com/healthcare

Health & Medicine

John Crawford, IBM