Personal Health Record market ecosystem: an analysis of Key Success Factors

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1 Personal Health Record market ecosystem: an analysis of Key Success Factors France Telecom, Orange Labs R&D Centre By André SCHILTZ, Jean-Marc TEMERSON and Gilles ZANOLIN

2 Warning This study does not cover The analysis of the benefits of using Personal Health Records (like controlling and organizing health records for the Patient, the Healthcare Providers, the Payers, the Insurers, the Employers ) The analysis of the potential of Personal Health Records to fulfill the current requirements of privacy, security, interoperability This study covers The analysis of the factors that allow some PHRs to be successful in terms of economic viability and sustainability 2

3 Outline Context and definition: Digital Health Records (PHR, EHR, EMR) PHR Market forecast and Hype Curve PHR market ecosystem: Different healthcare ecosystems: US, Japanese, French, European Choice of PHRs & Typology analysis Description of Key Success Factors Analysis of the PHRs with our KSFs Conclusion 3

4 Definition of generic Digital Health Records EMR: Electronic Medical Records are generally used/own by health professionals only. EHR: Electronic Health Records are systematic collection of electronic health information about individual patients or populations # (national) n-ehr provided by governments. PHR: Personal Health Records are health records maintained and owned by an individual. Hospital/Clinic/PACS Health Care Systems (Governments, institutions, Medicare and Medicaid EHR Programs in USA) EMR EHR Wellness providers PHR Patient PHR PHR Provider (MHV, Insurers ) PHR e-phr Chronic care Providers Enterprises (DOSSIA ) 4

5 PHR market ecosystem: Definition: Digital Health Records (PHR, EHR, EMR) PHR Market forecast and Hype Curve 5

6 2013 Global Digital Health Records Market forecast Digital Health Records Electronic Medical Record 9 G Personal Health Record Electronic Health Record 5.2 G 4.9 G 2013 DHR global market: 19 G EMR is a growing market (2 G for PACS) : McKesson 3.1 G$, Cerner 1.85 G$, Siemens 1.58 G$ - GE Healthcare 1.3 G$, etc. PHRs still in a nascent market 6

7 Market forecast A tool: the Gartner Hype Curve GARTNER Hype Curve : a tool to measure the maturity, adoption and social application of specific technologies 7

8 The 2010 Gartner hype curve PHR a nascent market 8

9 PHR market ecosystem: Definition: Digital Health Records (PHR, EHR, EMR) PHR Market forecast and Hype Curve PHR market ecosystem: Different healthcare ecosystems: US, Japanese, French, European 9

10 PHR market ecosystem: Different healthcare ecosystems => Different PHR market ecosystems USA France Japan USA: more than 100 PHRs. Elsewhere: EHR pushed by gvts & few significant PHRs (30% free; 70% paid) 7% patients & PHRs online, 3.2% users 10

11 The PHRs analyzed Definition: Digital Health Records (PHR, EHR, EMR) PHR Market forecast and Hype Curve PHR market ecosystem The PHRs analyzed in this study - Selection of some successful PHRs Success = economic viability and sustainability Criteria: not the number of users (Google Health stopped with more than 1 million users ) Use cases with enough figures and information (to inform the 12 KSFs) - Selection of some (currently) viable PHRs with reliable figures announcement to inform our KSF grid 11

12 The PHRs analyzed is there a typology? US Employers Fre e Card, Web, Mobile Norway AHIMA Fre e Insurer $ Fre e Platform Fre e Fre e FR Insurer/foundation Portal/Ins/Chr.D. FR Chronic Disease Portal Fre e EMR & Sensors link $ 12

13 Analysis of PHRs typology Push Governments (link & EHR) Enterprises Insurers Hospitals, emergency, foundations for & not-for-profit Organizations Platforms (with 3 rd apps ) Health Portals Chronic disease DHR Pull Wellness Devices & Portals eprescription Patient family history, hospitalizations, allergies, EMR, test results, vaccinations, medications, appointments, reminders, stop smoking, wellness 13

14 Classification of PHRs Push Governments (link & EHR) Enterprises Insurers Hospitals, emergency, foundations for & not-for-profit Organizations Platforms (with 3 rd apps ) Pull Health Portals Chronic disease DHR Patient family Wellness Devices & Portals eprescription 14

15 Outline Definition: Digital Health Records (PHR, EHR, EMR) PHR Market forecast and Hype Curve PHR market ecosystem: Different healthcare ecosystems: US, Japanese, French, European Typology of PHRs analyzed in this study Selection of Key Success Factors KSFs from previous analysis [paper in Med-e-Tel 2011] Analysis of business models use cases for ehealth in Europe and in Japan (KSF: Success measured as viability of the solutions) Example & Test grid of selected PHRs 15

16 Key success factors that PHRs must have (KSF: Success measured as viability of the solutions) Key success factors Government/organization legitimacy A free service for the patients A better service for citizens In-house expertise Partners' expertise Network and Platform management legitimacy Secure transmission & hosting Pre-existing distribution channel Appropriate interoperability and standardization Cost reduction Incentives for patients PHR proposed with/in another service Importance for the PHRs Important because PHR will/should be connected to EHR Important in Fremium mode: the basic PHR should be free Very important because PHR must meet the customer needs Existing expertise plus specific expertise from Partner Important to choose a partner having complementary expertise Even if there is a Telco expertise, it is important to get legitimacy Very important to ensure Security and Privacy of health data Important to have distribution channels (stores and/or internet) Important to highlight existing expertise in interoperability PHR should allow a reduction in costs in all health circuits Very important to get customer adhesion by incentives Very important because patient needs today another motivation 16

17 Example of Google Health using analysis from literature [John Moore of Chilmark Research] 10 Reasons why Google Health failed [Andrew Brown of Strategy Analytics ] Is Google leaving the Healthcare market too soon? 17

18 Test grid of the selected PHRs vs. KSFs Analyze 10 (currently) successful PHRs with the KSFs from previous analysis Some systematic (important) KSFs - Better service / Secure transmission / Interoperability / Incentives / PHR proposed with another service Not so necessary or important KSF? - Free service for the patient (consistent & fact 70% paid PHRs in USA) 18

19 Outline Definition: Digital Health Records (PHR, EHR, EMR) PHR Market forecast and Hype Curve PHR market ecosystem: Different healthcare ecosystems: US, Japanese, French, European Typology of PHRs analyzed in this study Selection of Key Success Factors Analysis and conclusion 19

20 Analysis Analysis of some (currently) successful PHRs => Push/Pull & important KSFs - PUSHED by: Health insurance plan funded by Enterprise/ Government/ Foundation - PUSHED/PULLED by: 3 rd applications (and/or partners) platform - PULLED by: Portal - Chronic disease dedicated portal/platform - Wellness portal & associated devices and services - eprescription platform - Services to the Patient - Needed KSFs: Better service - Secure transmission Interoperability & std Incentives Proposed with/in support with another service 20

21 Conclusion In such a nascent market, patients today need another motivation than just those claimed by conventional PHRs To reach market maturity, PHRs will need to go through the following phases: - Obtain a full adoption by patients (customers) - Get a clear role and good ecosystem comprehension (push/pull) - Get a clear business model and position with partners on the value chain 21

22 Thanks 22

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