The Future of Digital Healthcare

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10 TRENDS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Empowered & Informed Patients Resource Scarcity & Cost Cuts Self-Service Express Looking for a Better Experience Open Innovation Fun = Engaging Care Tech Mobility Who Cares Humanized Tech

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 INFORMED PATIENTS Shared decision-making. You are the CEO of your own health. High expectations for involvement and engagement with healthcare. Far from being cost drivers, empowered patients are an integral part of a sustainable healthcare system!

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Trend 1 EMPOWERED & 
 INFORMED PATIENTS Trend intro Facts about the trend Challenges In order to reach a more collaborative understanding of their health, patients now and in the future feel empowered to question their doctors’ views and assumptions. They take some responsibility for their health by selfdiagnosing and self-medicating. Empowered patients are an asset to a society. (European Patients Forum 2015) Research shows that three out of four people seeking health information online do not consistently check the validity of the information they find. Develop competencies and adapt relevant technology that helps professionals support selfmanagement by patients. Privacy issues, cyber criminals, lack of health data privacy awareness. UIs for different user segments, e.g. silver surfers. Patients want to play a more active role in the management of their health. They want to be engaged, empowered and educated. 81 percent of people 65 and over in the US say that technology is important in their everyday lives and 68 percent of them consider technology to be “very important” or “somewhat important” for managing their health. (Accenture 2015) Healthcare systems, providers, policy makers and designers need to ensure empowerment and “consumerization” don’t undermine care quality by demanding more from patients than they can be expected to deliver.. Adopt a new Healthcare Engagement Model. Providers can cut costs, free up clinicians and deliver better health outcomes. Patients should be seen as consumers and “co-producers” of their well-being, not just of better health. Informed patients are more likely to follow a clinician’s prescribed medication and treatment plan. At least 80% of patients in the UK actively seek information about coping with health problems on the Internet. (European Patients Forum 2015) A 2010 study found that 60 percent of diabetes patients who had access to a portal with information about their condition had improved health outcomes (“Patient Web Portals to Improve Diabetes Outcomes: A Systematic Review”, National Centre for Biotechnology Information, USA, 2010. ) Opportunities Education about health data privacy.

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TREND 2 RESOURCE SCARCITY & COST CUTS Doing more with less. Costs will decrease as care transitions from capital intensive to remote monitoring. “In healthcare it’s not necessarily about how to generate more revenue per patient. It’s about how to take better care of the patient.” (Jeff Fountaine, Honeywell 2015)

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 & COST CUTS Trend intro Facts about the trend Challenges Care delivery should focus on providing value, quality and prevention. Quality care prevents patients from having to seek out more costly healthcare services. Aligning resources with strategic priorities and applying modern industrial engineering techniques, such as standardizing processes and the flow of patients through the facility, can reduce health plan administrative costs by as much as 25%. (www.strategyand.pwc.com) Transparency, clear pricing information for patients Hospitals and other healthcare providers are striving to control increasing healthcare costs. Providing patients with the option of monitoring their own condition with intuitive medical devices and branded apps can reduce costs noticeably. A US study found that hospitals offering a superior patient experience tend to have 50% higher margins than their peers. (Accenture 2015) Costs will fall as care transitions from capital intensive “brick and mortar” to remote monitoring as well as digital and mobile patient engagement. According to innovative cardiologist Eric Topol of Scripps Green Hospital in La Jolla, CA, inexpensive mobile ultrasound scans performed as part of routine exams and cheap smartphone add-ons that can serve as EKG monitors can eliminate $600 per visit when compared to performing the same test using a full-scale machines. Figures suggest that 6.9 million outpatient hospital appointments are missed each year in the UK, costing an average of £108 per appointment in 2012/13. Missed appointments can cause serious delays in treatment for other patients. Simple initiatives like sending email and text reminders are now used by many clinics and have had an impact: outpatient DNAs have fallen to 9.1% from 10.5% in 2008/9. (www.england.nhs.uk) Patient engagement. If they don’t receive timely treatment for their conditions or don’t keep up with their recovery instructions, they end up needing more intense and expensive care down the line. Opportunities In addition to potentially lowering costs in the long term, patientcentered care models are already contributing towards higher quality of care and a better patient experience. Technology improves nursing productivity and satisfaction, increasing patient satisfaction. Timely treatment & engaged patients. Integrated delivery networks, health information exchanges, accurate patient data & records and access to information increases service, speeds up processes and decreases costs. Providing transparent pricing. Providing patients with telehealth services once they’re discharged. Follow-up via branded, gamified apps and devices.

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TREND 3 SELF-SERVICE EXPRESS Meeting people where where they shop, live, work, play. Affordable prices for on-the-go services as a part of prevention and wellness protocols. Online tools, mail order.

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 EXPRESS Trend intro Facts about the trend Challenges Encountering people where where they shop, live, work & play. 85% of U.S. health consumers say that email, text messages and voicemail are at least as helpful as in-person or phone conversations with healthcare providers (Healthy World study, Technology Beyon the Exam Room by TeleVox). Technological maturity Care quality vs. cost Care quality vs. cost Mobiles and watches are great assets for on-the-go services, thanks to access regardless of time and location. Regional hospitals are adapting existing retail facilities. Spaces within well-situated retail centers now often act as frontline facilities for major health systems. Affordable prices for on-the-go services. Wearable as part of prevention and wellness protocols. Mail order pharmacies Online tools for choosing a doctor. 1/3 consumers admit to being more honest when talking about medical needs via automated voice response systems, emails or texts than face-to-face. (Healthy World study, Technology Beyon the Exam Room by TeleVox). 1/3 consumers who participate in online activities are keen to use smartphones or tablets to “do” health online. (theharrispoll.com) When is high-tech appropriate, when high-touch. Opportunities

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 BETTER EXPERIENCE Patients as consumers expect convenience regardless of location. Offering a natural and convenient fit for health and fitness-oriented visits. Carefree and smooth health information exchange and delivery network.

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 BETTER EXPERIENCE Trend intro Facts about the trend Challenges Today’s patients are consumers and have high expectations for healthcare customer experiences. Mothers are the healthcare gatekeepers for families. When 70,6% of mothers are juggling busy schedules at work and at home, convenience becomes an important factor in healthcare provider selection. Unlike other businesses that only care about giving consumers what they want in order to make a sale, healthcare professionals have a responsibility to provide the public with what it needs - even when it’s not necessarily what it wants. Offering patients the option of paying a visit to a nurse practitioner when making health- or wellness-oriented purchases. Urgent retail clinics and convenient opening hours. Caregivers should have easy access to patients’ previous medical information if they have questions or need additional information (Integrated delivery networks). A Harris Interactive/ HealthDay survey reports the number of people who use the retail health clinics has jumped from 7% in 2008 to 27%. Unsurprisingly, younger adults are more likely use this type of clinic than older adults. 40% of adults between the ages of 25 to 29 used a retail or workbased clinic versus only 15% of adults aged 65 and older. Patients don’t really want to be there. Opportunities Transparent pricing via collaboration Hospitals and healthcare providers should learn how to provide a better experience by benchmarking other industries - particularly the retail industry.

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 INNOVATION Networking, collaboration and partnering. Consumers as producers and co-creators. Open innovations break down silos and are likely to be created locally.

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Trend 5 OPEN
 INNOVATION Trend intro Facts about the trend Challenges Open innovation in healthcare relies on the involvement of physicians, nurses, pharmacists, patients and other individual inventors - they define what services they want to consume as well as when and where. Institutions that use open innovation — Unilever Global, Samsung and Edison Nation Medical, etc. — call on inventors to confidentially submit their ideas to teams of experienced evaluators, legal professionals and commercialization experts. These companies have a variety of means through which an inventive idea can be commercialized, including startup accelerators or incubation models. (Medical Product Outsourcing) Healthcare companies still tend to rely on outdated administrative technologies, which slows innovation down. Bridging the technology gap requires significant financial investment, effort and commitment on the part of healthcare systems. In the medical technology community, open innovation provides diverse professionals with the best understanding of a problem, empowering them to create a solution. The best innovations are likely to be created locally. Opportunities Patients living with chronic conditions are sometimes referred to as “the most under utilised resource in the healthcare system”. Connect relevant people to cocreate and help the industry innovate. Platform creation, access to the best insights from the community and use of open APIs from startups that provide services benefiting platform creators and their customers.

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TREND 6 FUN = ENGAGING Drives prevention by changing behaviour. Engages, motivates and boosts social status in a fun way. Educates in telehealth programs.

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Trend 6 FUN = ENGAGING Trend intro Facts about the trend Challenges Gamified health tracking creates an environment that keeps the patient from straying from the appropriate therapy path. An estimated 50% of patients with chronic diseases do not follow the prescribed treatment. (Forbes, Dr.B.Meskó, 2014) Creating a real understanding of what motivates your desired audience and keeps them interested. Findings support current efforts to develop effective gamified intervention for education and training in health care. Violations of Federal patient privacy regulations Gamification makes interactions with patients more effective and also helps provide tangible, engaging and motivating feedback. Motivating factors include status as well as public display of achievements and accomplishments. Data is collected and analyzed to improve and enhance interactions between the gamified program and the user. Also used in some telehealth programs to educate patients, health workers and the general populace in remote and rural areas. 85% of the tasks in our daily lives will include game elements by 2020. (Electrical and Electronics Engineers 2014) Packy and Marlon, a game designed to help kids better manage their juvenile diabetes, lead to a 77% reduction in the players’ diabetes related urgent care and emergency clinical visits. (edisonpartners.com) Pain Squad a smartphone app for pain management, helped increase selfreporting of symptoms by young cancer patients from 11% to 90%. (MobileSmith, Inc. 2014) Players’ personal data protection. Can users make meaningful choices? Are they challenged? Are they in control? Who’s playing? Who’s collaborating? To whom will users display their status? Keeping in mind the different needs and baselines of different kinds of users. Opportunities

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TREND 7 CARE TECH Wearable sensors collect data without interfering with our daily lives, helping us make better and more informed decisions. Collected and shared data improves quality of life and enables better care and security.

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Trend 7 CARE TECH Trend intro Facts about the trend Challenges Technology allows us to measure critical health parameters in convenient and inexpensive ways - tiny, wearable, sensors collect data without inferring with our daily lives and help us and our caregivers make better, more informed quantifiable decisions. Jupiter Research projects that the wearable technology market will be worth $19 million by 2018. Almost nothing can be done In the medical device industry without the involvement of compliance lawyers. Tractica forecasts that consumers utilizing home health technologies will increase from 14.3 million worldwide in 2014 to 78.5 million by 2020. A common concern is that consumers initial excitement with with wearables will fade away if they have limited success achieving their health and fitness goals. Patients have choices regarding the purchase of many digital health technologies. In the future, choices will increase with the awareness and development of more robust, impactful, diversified and integrated technologies. Web-based portals that enable regulatory compliant video interactions between patient and clinician are now supported by a wide array of webintegrated wireless monitoring devices. PwC asked consumers what was more important to them: privacy or convenience. The answer depended on the type of data. 73% rated the privacy of their medical records as more important than convenience of access. For data regarding diet and exercise, ca. 60% percent said convenience of access was more important than privacy. (HRI, PwC, 2014) Management of chronic diseases still consumes about 70% of healthcare costs. Only 30% is spent on preventive healthcare and wellness. (FierceMobileHealthcare, 2013) Opportunities A remote monitoring device, a wearable or an implantable that is intuitive enough to sense patient status will boost patient confidence in using IoT devices and provider confidence in recommending and prescribing them. The combination of technological maturity, consumer eagerness to use apps as well as devices and physicians’ willingness to work with the data all point to home health care as a major trend.

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TREND 8 MOBILITY Feel cared for and connected. Inform and be informed, reach and be reached. Millennials are major drivers of healthcare disruption and will demand the healthcare system offer them convenient mobile and digital tools.

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Trend 8 MOBILITY Trend intro Facts about the trend Challenges Millennials are major drivers of healthcare disruption, as developers of new technologies, founders of new companies and a large new insured population that will demand the healthcare system offer them convenient mobile and digital tools. All consumers, regardless of generation, welcome the era of personalized medicine via digital communications, and are looking for these messages to be personally tailored. 49% are open to receiving medical care between visits via email, so there’s consumer demand for telehealth services. (Healthy World study, Technology Beyond the Exam Room by TeleVox) Mobility carries security risks.; malware, thefts, cyber attacks can harm confidentiality and erode patient trust. The universality of digital communication means that many doctor-patient contacts are now virtual and deliver care to the patient in their home, especially in remote areas of the world. Home healthcare services and innovative technology will allow for doctor-patient connectivity in previously unavailable places, saving both lives and money. Patient monitoring before, during and after a procedure can now include autonomous robots. Mobile technology trials showed a 15%-20% reduction in hospital days and 30% fewer ER visits. (MobileSmith, Inc. 2014) The mHealth market is forecast to be a mass market, potentially reaching billions of smartphone and tablet users, by 2017. (iercemobilehealthcare.com) A report by research2guidance predicts that mobile healthcare services market will begin the commercialization phase and reach $26 billion worldwide by 2017, as smartphone apps enable the mHealth industry to monetize these services. . (fiercemobilehealthcare.com) Opportunities Use of mobile devices for diagnostic procedures is increasing and they are more frequently performed at home. Prescribed medical mobile applications will be customized. “The smartphone will be the hub of the future of medicine,” says Meskó, “serving as a health-medical dashboard. “(Forbes 2014) Mobililty is the key factor making healthcare quick, portable and personal.

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TREND 9 WHO CARES Patient, family & healthcare provider share and coordinate the patient’s medical data and history. Instant interaction between family and care providers guarantees a smooth and flexible experience.

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Trend 9 WHO CARES Trend intro Facts about the trend Challenges Technology keeps a patient’s primary care provider up to date on the patient’s health records, even if the patient is going elsewhere for treatment. Improved patient safety is one of the most promising advantages provided by a health information exchange (HIE). Up to 18% of patient safety errors and 70% of adverse drug events could be eliminated making the right information about the right patient available at the right time. Health information exchange makes this possible. (doi:10.1016/j.jbi.2007.08.011) When necessary for their medical care, patients are willing to share their health information. But if they feel it’s not being shared securely, they’re likely to seek care somewhere else. To better track and securely share a patient’s complete medical history, more healthcare providers are participating in health information exchange (HIE). HIE helps facilitate coordinated patient care, reduce duplicate treatments and avoid costly mistakes. Constant communication with the family by healthcare providers can make a stressful experience easier. Consumer-mediated exchange provides patients with access to their health information, allowing them to manage their healthcare online. There is a risk that this kind of information sharing could put the patients’ private data at risk, damaging a crucial component in healthcare management - for both patients and doctors. Opportunities HIE should reduce documentation time, automate critical processes in preventive and chronic disease care and reduce medical errors. Doctors and caregivers can see online whether the patient recently had a test or procedure, as well as the the results. No need to repeat the procedure. This saves time and money. By preventing duplicate tests and procedures, HIE makes health care less expensive for everyone.

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TREND 10 HUMANIZED TECH How do I feel? Get educated about a healthy lifestyle. Personal needs and preferences are fulfilled.

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Trend 10 HUMANIZED TECH Trend intro Facts about the trend Challenges The new patient-clinician partnership is based on improved awareness, self-management and prevention strategies. Tailored mobile apps for senior care facilities, as well as condition-specific apps for patient education and monitoring of symptoms, appear to form an efficient patient engagement strategy for this expanding and costly demographic. 5.4 billion worldwide machine-tomachine connections by 2020. A solution is Internet Of Things if it’s: A clear vision and high-quality care as a defined goal are needed to use technology to its fullest potential. Aware - The connected asset is able to sense something about its surroundings Autonomous: - The data from the asset is transferred seamlessly and automatically Actionable - Analysis of the data is integrated into the business process Designing and implementing technology with the sole aim of increasing profits does not produce an optimal outcome and should be avoided. Behavioural healthcare design is big part of healthcare design. Design criteria that drive any healthcare facility are creating humanized interior spaces that respect the patients’ dignity, ease patient anxiety and improve the healthcare delivery process. (news.verizonenterprise.com/2015/03/ healthcare-iot-humanizationtechnology-connected) Monitoring devices and platforms with complicated user interfaces and complex mobile applications will never breach today’s tech divide. Smart devices, especially for the elderly, must be intuitive enough to require limited patient programming and interaction. Opportunities By utilizing the emotionally sensitive nature of health care design criteria in the holistic healthcare design process, patients will be engaged and feel safe.

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 INFORM YOUR PATIENTS Your patient can monitor his or her condition anywhere and anytime, discreetly. The results are automatically shared with all relevant parties and caregivers. The patient receives immediate feedback and can take action to maintain health routines. Treatment by a physician can be ordered when necessary, but empowered and informed patients don’t visit physicians gratuitously. Empowered patients utilizing seamless service experiences, far from becoming cost drivers, become the CEOs of their own health and wellbeing!

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FUN = ENGAGING Co-operate with your patients and diverse professionals to create environments for discovering and developing new innovative solutions for today’s healthcare. Gamified health tracking keeps the patient on the appropriate therapy path. Gamification allows patients to achieve social status and share accomplishments in their social networks.

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 THOSE WHO CARE Your patient’s family wants to know how their loved ones are. Share and coordinate the patient’s current health state & real-time medical data and history. Instant interaction between family and care providers guarantees a smooth and flexible experience. A seamless connection saves time and money for everyone.

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GO OPEN INNOVATION Meet healthcare consumers and professionals in their own environment. Learn and understand their needs, constraints and goals. Use and analyze available data. Establish methods for co-creation.

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// Thank you! We create digital services for people to love and help our customers to succeed in digital world. Written by Salla Heinänen, Mirkka Länsisalo, Jane Vita Visuals Tommi Karjalainen Editor Arttu Tolonen

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