Tuesday, March 28, 2006

 

Healthcare Industry - Chuang, Gaerlan, Nguyen, Tewari

As we have learned in class, the increasing ability to communicate electronically via increase in bandwidth, connections, and computer processing power has brought about the Network Era. This directly affects the healthcare industry because of the sheer amount of more readily accessible data.

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:

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:

source: http://www.sap.com/industries/healthcare/index.epx

Nguyen - WEBMD.com (NYSE: HLTH)
source: http://www.webmd.com

WebMD is now Emdeon Corporation with 4 Segments:

  1. Emdeon Business Services
  2. Emdeon Practice Services
  3. Webmd Health
  4. Porex

    "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."

Tewari - AETNA Inc. (NYSE: AET)
data sources: http://www.aetna.com, http://finance.yahoo.com

Aetna is one of the nation's leading providers of health, dental, group, life, disability and long-term care benefits.

Membership:
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
4,323 hospitals
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.


Comments:
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Notes to self:

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.
 
More notes to self:

Network connections across industries - are there any and how do they affect?

How do customers connect to other customers? What is their influence?
 
what about data management? gems as taken a position in healthcare information management. doesn't it belong in your stack? or is it there and hidden in something else?
 
take a look at http://msdn.microsoft.com/windowsvista/learning/training/conceptvid/default.aspx
 
More notes to team:

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?)
 
another note:

"smart objects" - another example is the i-pot in japan
 
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