Tuesday, March 28, 2006
Healthcare Industry - Chuang, Gaerlan, Nguyen, Tewari
With the move to the digitization of medical records, for example, there is an incredible opportunity for clinical data exchange between healthcare providers, payers (insurance, etc), patients, and others.
Our preliminary research into the industry has shown that several issues regarding Electronic Medical Records (EMR) create an interesting landscape for the players (outlined in the Healthcare Stack image) at different levels:
- Lack of standards for interoperability
- Government policies, security, and privacy issues
- Doctors don't know what to purchase
- There is no architecture for the exchange of data
- There is a lack of alignment of incentives for clinicians
- Technology regarding digital imaging might not be there
Aside from EMR, there are other factors affecting the healthcare industry. With information more readily available about doctors to facilitate their evaluation by prospective patients, there may be a shift in patient requests (within their healthcare plan) for particular hospitals/doctors/etc.
Another thing to consider is the amount of data available to patients in relation to diagnosis of problems - traditionally patients used to go to their doctors only for information (and at most sought a second opinion) but are now turning to web based information to self diagnose.
In addition, there are other issues to consider regarding the increasing accessibility of data...but we haven't covered them all and would appreciate input from the class (and any other lurkers that may browse this blog).The Healthcare Stack: players jockeying for position
(caveat: this is a draft and will be changed according to further research)
So how will this affect certain players within the layers? Each of our team members has chosen to do further research as outlined below:
Chuang - IBM Consulting Services (NYSE: IBM)
IBM provides consulting services and solutions to help implement EMR in hospitals and HMOs to allow the standardization of patient data within the healthcare industry. IBM's solutions include:
- Clinical care and Medical imaging
- Life Sciences R&D
- Regulatory compliance
- Clinical genomics
- Payer transaction services
Gaerlan - SAP (NYSE: SAP)
At the ERP systems level, there is a great opportunity for sales and support of modules which integrate EMR. However, from a business perspective once these modules are sold and integrated into the systems of all the players in the stack (granted, this will take some time but there is a finite amount of customers!), players at the ERP layer need to determine how they can generate more income. I have chosen to focus on SAP.
Currently, SAP ERP functionality for medical companies includes the ability to:
- "Manage and coordinate patient care, from pre-registration and bed assignments to patient education
- Access Web-enabled functions for patient management, diagnostics, and therapy
- Assess case loads, develop and implement treatment strategies, and document clinical care
- Communicate online with patients, payers, providers, general practitioners, suppliers, and other healthcare providers
- Take advantage of powerful data warehousing features for target planning, resource costing, case costing, and outcome management
- Focus customer relationship management on patients, external physicians, employees, donors, and other key customers"
Nguyen - WEBMD.com (NYSE: HLTH)
WebMD is now Emdeon Corporation with 4 Segments:
- Emdeon Business Services
- Emdeon Practice Services
- Webmd Health
"WebMD is the leading provider of health information and services toconsumers and healthcare professionals. The online healthcare information,decision-support applications and communications services that we provide: -help consumers take an active role in managing their health by providingobjective healthcare information and lifestyle information. -make it easier for physicians and healthcare professionals to access clinicalreference sources, stay abreast of the latest clinical information, learn aboutnew treatment options, earn continuing medical education credits andcommunicate with peers. -enable employers and health plans to provide their employees and plan memberswith access to personalized heath and benefit information and decision supporttechnology that helps them make informed benefit, provider and treatmentchoices."
Aetna is one of the nation's leading providers of health, dental, group, life, disability and long-term care benefits.
14.8 million medical members
13.1 million dental members
9.4 million pharmacy members
13.6 million group insurance members
Health Care Networks:
More than 721,000 health care professionals
More than 431,000 primary care doctors and specialists
A network of specialist physicians, AexcelSM, based on clinical performance andcost efficiency.
Products and Programs:
1) Aetna offers a broad range of insurance and employee benefits products.
2) The first national, full-service health insurer to offer a consumer-directedhealth plan, Aetna continues to lead the way with its Aetna HealthFund line of products, including HSA, HRA and RRA options.
3) Aetna offers a wide array of programs and services that help control rising employee benefits costs while striving to improve the quality of health care, such as case management; disease management and patient safety programs; integrated medical, dental, pharmaceutical, behavioral health and disability information.
4) Aetna provides members with access to convenient tools and easy-to-understand information that can help them make better-informed decisions about their health and financial wellbeing.
1. does privacy become its own layer, will we pay a company to ensure security of our data
2. with move to payment by consumer, is there power shift
3. with more info availability to evaluate by doctor/plan etc, what is affected? As with 2 is there disintermediation between recommendations from employers or insurance and actual choice?
4. more research on info sources - used to completely trust doctor, now quesstion every decision/diagnosis. Other issue - authenticity/veracity of data
5. government - HIPAA regs etc.
Network connections across industries - are there any and how do they affect?
How do customers connect to other customers? What is their influence?
1. effect of "smart" objects ("pacemaker call for help?")
2. idle pc accelerate discovery ("cure for aids app")
3. video game visualization facilitating understanding of biological systems
4. Wiki's and blogs
5. Wi Fi
6. social networking
7. security issues with power of data - tech risk radically minimized but culturally unacceptable?
8. sourcing competencies changing geography of work (does this affect industry?)
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