Reenita Das, Partner, Healthcare and Life Sciences at Frost and Sullivan, talked about worldwide transformation that is happening in healthcare, and its impact on medical device industry, at www.bio2devicegroup.org event.
What is taking place right now is a massive global remix, with merging of disciplines, cross pollination of ideas, technology, and applications. With the shifting of the boundaries, a new world is emerging, said Das. The business model is shifting from one size fits all, provider centric, procedure based, capitated model to personalized, patient centric, bundled, value based approach to healthcare. Unlike previously fragmented approach, hospitals and payors will increasingly look at more decentralized, community based, integrated approach to treating diseases where the focus will be on preventing diseases, not on treatment of diseases, said Das. This is a new reality where hospital will not be the first, but the last option, in disease management.
Currently, 80% of dollars are going into treating 20% of the population, over the age of 65. There is a shift under way to move cost of dollars from end stage to “at risk” patients and that will be a bitter pill to digest for companies that are reaping profits from treatment of chronic diseases. As the focus grows on moving away from treatment, after the disease progression, to moving towards earlier prediction with an aim to improve the quality of life, the medical device industry will be impacted with shift in dollars. In order to improve the quality of life, it is important to have earlier screening with better prediction of susceptibility to certain diseases, so as to begin preventive treatment earlier. Dollars will move away from medical devices that focus on treatment to those that focus on monitoring, diagnosis, and prediction. In 2012, 60% of healthcare dollars were spent on treatment of diseases and only 19% went into diagnosis. Das said, in 2025, only 35% of the dollars are expected to go towards treatment, while 27% will go towards diagnosis, 22% towards prediction, and 16% in monitoring of disease progression. Das’s advice, “don’t compete in the treatment space, it is becoming smaller.”
As Asia emerges as a major focus for healthcare spending, there will also be a greater focus on holistic way of treating diseases. Between 2010 and 2020, healthcare expenses in the US will be $3922 billion. But spending more money does not translate into better healthcare and there will be increasing pressure to spend less. Simultaneously, there will be growth in healthcare spending in Asia, with $1446 billion of healthcare expenses in China, $331 billion in India, $31 billion in Vietnam and so on. Asian hospital brands will become global brands, in the next ten years and emerging markets will also become very competitive, with increasing interest in “reverse innovation”, where cutting edge cost effective innovations in developing countries, will be then brought to US and other Western markets. Between 2010 and 2020, Asia is likely to grow 150%, said Das.
Developing countries are emerging as meccas for cost effective healthcare. Additionally, they are making better and more widespread care available to indigenous populations. China, for instance, has eliminated the definition of poverty, as it has eliminated poverty. By 2020, China expects 100% healthcare coverage for all Chinese people. BRIC represents 2.9% or 40% of world’s population. These and other emerging group of nations will likely influence innovation, choice, and spending on healthcare.
Business process change will emerge as one of the biggest challenges in healthcare. What was once a payment is now a cost, what was once a cost is now a potential savings. Data will emerge as the holy grail, as everything becomes data driven. There will be focus on data integration and democratization of data. There will be an emphasis on risk sharing and focus on mobility and security of information. Patient engagement is a challenge that will have to be addressed, to close the integration gap. Currently, majority of the patient portals provide secure access to medical records, and ability to schedule appointments, refill prescriptions, and so on. However, there has been little success in achieving behavior modification, individualized outreach, efficient platforms to enable search and access of relevant information, efficient platforms for social media interactions, efficient platforms for mHealth applications and so on. So lot of work needs to be done.
How will the changes impact how medical technologies are evaluated and purchased? With increasing cost pressures, there will be a shift in payments based on quality plus cost and focus on value over volume and procedure based reimbursement. This will bring new challenges with respect to new pricing models, cost of adoption, impact on workflow, integration of information, and slower adoption of new technologies. Decisions will be increasingly made by committees of finance people, in addition to the clinicians. As purchase decisions move away from clinicians to hospital administrators and products increasingly become commoditized, US will shift from being exporter to importer of medical technologies. The new realities will make it imperative that companies fail fast.
Where are IT solutions are failing to reach the holy grail, in the realm of data? There is lot of data being generated and there are also predictive analytics. However, data integration is lagging behind. Currently, data is provided in separate solutions. Additionally, the predictive analytics are not translating into action. So although the technology has arrived and applications are available, solutions are not there. There will also likely be fewer employer contracted health plans as more employers like Sears and Olive Garden choose to offer cash for plans or money to pay for healthcare. This trend goes along with the fact that one size does not fit all and there has to be personalization of healthcare coverage.
There is also more cross industry convergence between healthcare and other industries like automotive, information technology, energy and so on. The top five technology trends are 1) Interoperability that can bring new technologies capable of integrating medical devices into a connected platform to enhance functionality and minimize errors; 2) Multifunctional; 3) Capable of Big Data integration to enhance functionality for diagnostic and treatment devices; 4) Low-Cost; and 5) Nanotechnology that provides benefits biocompatibility, and functionally at an unparalleled scale and is better able to influence diseases at a cellular level. Das predicted, there will be growth in the areas of structural heart, robot assisted technologies, infection control, home health care, and neurological devices.
Finally, just as you accumulate miles for travel, customers will accumulate miles for better health. As healthcare become increasing data driven and there is increased use of analytics to define care pathways, there will be incentives for patient engagement, greater use of remote health monitoring and mobile apps, and new care models will emerge based on collaboration, information exchange, awareness, and achieving health outcomes, particularly in case of chronic diseases.
Das’s comprehensive informative presentations generated many questions and was followed by Q&A.