Social Innovation in Health and Wellness

Transcription

1 Social Innovation in Health and Wellness Leveraging Japan s healthcare industry assets in service design and big-data analyses and exporting them to the world. Innovation in Health & Wellness with the NHS in Greater Manchester

2 Innovation in Health & Wellness with the NHS in Greater Manchester Social Innovation in Health and Wellness Leveraging Japan s healthcare industry assets in service design and big-data analyses and exporting them to the world. Hitachi offers healthcare products and services that manage and leverage health and wellness data collected through wearable devices, health sensors and other sensing and scanning modalities, by analysing and converting this information into valuable health and wellness intelligence across the entire care cycle. The company recently started expanding its healthcare services business by redesigning and customizing its existing service offerings, built uniquely for the Japanese market, for global markets. Hitachi s Healthcare IT Services Business in the Greater Manchester region of the United Kingdom was established as an exemplar of this and Hitachi Consulting was tasked with planning, coordinating and preparing the initial delivery of this project. Hitachi Consulting was instrumental in orchestrating the collaboration between the Hitachi Group and the National Health Service in England. Project Team (R to L): Satoru Urakami, Kshitij Kumar, Steven Zhang

3 Satoru Urakami, Project Leader: On the basis of this new initiative, many organizations within the Hitachi Group, including the Information and Telecommunication Systems Company, the Central Research Laboratory, the Yokohama Research Laboratory, the Design Headquarters, and Hitachi Europe worked in close unison. I believe that this highlights the strengths of One Hitachi. Healthcare Services Business as an Important Building Block of Social Innovation In recent years, there has been an increasing awareness in Japan about being the fastest ageing population in the world, which in turn is increasing healthcare costs and is being identified as a serious social issue. However, Japan s health expenditure as a percentage of GDP is still only 9.6% (OECD Health Data 2013), ranking it 12th among the 34 OECD countries, while per capita healthcare cost is ranked 18th globally. For a country whose peoples boast the world s longest average lifespan, these figures are not as high as one would expect. The relatively lower cost of Japan s healthcare services can in part be attributed to the national health insurance framework, an above benchmark level of diagnostic capabilities and a robust vaccination program. As a result, many countries pay close attention to Japan s healthcare system of services, holding it in high regard. Traditionally however, language, social-economic and cultural differences have made it difficult to transfer and implement Japan s best practices overseas. Hitachi, one of Japan s biggest conglomerates, regards its healthcare services business as an important building block of social innovation and has set in motion initiatives to extend its services portfolio to respond to needs from the global healthcare sector. As a first step, a pilot project to improve healthcare services in the city of Salford (Greater Manchester, England) was established in October 2013, leveraging Hitachi s IT and innovative business capabilities. Satoru Urakami, project manager at Hitachi Consulting, describes how this project came into being. Healthcare is an extremely important social issue worldwide and the market will continue to expand into the future. By recognizing healthcare as one of the pillars of social innovation, the Hitachi Group has taken the initiative to aggressively pursue global healthcare development. Responding to this call to action, Hitachi Consulting conducted a survey of healthcare market trends and systems in different countries, closely keeping an eye on those that share Hitachi Group s vision. After much deliberation and analysis, the Manchester region in the UK emerged the obvious choice to approach as our first partner. According to Mr. Urakami, a comprehensive survey was conducted across several developed countries including Japan, as well as other world economies where IT was already being implemented within the healthcare sector. It was found that the English system faced challenges similar to those of Japan, in particular, reducing healthcare expenses and improving the overall quality. Moreover, the English had already begun to embark on large-scale healthcare reform a few years earlier and this meant that they were already primed as a market. He adds, England was initially aiming to work with its medical institutions to advance the development of its primary care General Practitioners (or GPs) appointments systems along with establishing central patient database systems as part of the National Programme for IT (NPfIT), which was headed by the country s NHS (National Health Service). However, the scale of the project was too large to be implemented uniformly across the country. Public awareness regarding the use of medical data was not addressed resulting in less than satisfactory results. In

4 , the NHS shifted to a bottom-up approach where the commissioning of services and the management of data was to now be carried out by local GPs, using their choice of private sector resources. The timing was just right for us, and we knew that if we could successfully demonstrate a healthcare IT services project with the NHS in England, it would become a flagship business for Hitachi. So, we went into initiating the program with the resolution to succeed no matter what obstacles we faced. Investigate Ways to Improve Healthcare Services Although Hitachi has been manufacturing CTs, MRIs, and other cutting-edge medical devices for the domestic and overseas markets for years, the company has yet to expand their IT business for healthcare services overseas. To get the project off the ground, we worked with the UK Trade & Investment Authority (UKTI) to find appropriate business partners in the UK who we could collaborate with. Kshitij Kumar, manager at Hitachi Consulting, who lead the initial contact and lobbied on behalf of Hitachi explains, Hitachi has worked around the world on infrastructure projects, including gas, water, mobility, telecommunications and power, and more recently on high-speed railway projects in the UK, firmly establishing Hitachi as a brand. In the case of non-device healthcare services however, Hitachi was entering an entirely new market, and we purposefully decided to establish new routes without relying on Hitachi s previous contacts. This wasn t easy but we were able to present an ambitious vision with a bold, yet structured business scheme. When Mr. Kumar shared Hitachi s vision for the future of healthcare with the UKTI, he discovered that healthcare reforms based on a similar philosophy were already being tested in Salford, a city within the Greater Manchester conurbation, located about 300 km northwest of London. The region, with roughly 2.6 million residents, consists of 10 major cities, including Salford and the City of Manchester. As a lucky happenstance, Mr. Kumar who is an alumnus of the University of Manchester and had previously worked in Manchester had the opportunity to take advantage of his personal network both within the University and beyond and expedite the business development for this project. Unbeknown to Mr. Kumar, Greater Manchester was leading not only the UK but the world in having established the foundation for cutting edge innovation in health and wellness, in many ways was already primed for Hitachi to come and build upon the work already done. A majority of the GPs in the Manchester region had already implemented an interconnected electronic medical record system with an implementation rate of 99% for Salford in particular, where approximately 250,000 patient records had already been integrated. Mr. Kumar jokes that he felt a sense of pride and was on the next flight out to Manchester, I knew then that we could do something great here and deliver an innovative healthcare system if we could successfully add Hitachi s vision and expertise to what they already had. And the feeling was mutual because I had a very positive response the moment I presented our vision. The presence of Hitachi as a new player seemed to generate great expectations from them. In April 2013, Hitachi signed a Memorandum of Understanding with multiple partners in Manchester and Salford to investigate ways to improve healthcare services in the Greater Manchester region with Kshitij Kumar was born in India, but grew up in England. His background as an alumnus of the University of Manchester was invaluable to the success of this project. He comments: I have been travelling to England on an average of three times every two months since the autumn of My travel has been so frequent that I have seen most new movie releases in recent memory either on the plane or at the cinema in Manchester! The project has been demanding but has been immensely rewarding.

5 a focus on Salford. The project team was composed of Hitachi (including Hitachi Consulting), ten commissioning groups in the Manchester region represented by the NHS in Greater Manchester; Manchester Academic Health Science Centre; and North West e-health, an NPO that develops healthcare information systems. Manchester s regional position has engendered the smooth progress of this project. Steven Zhang, manager at Hitachi Consulting, who was in charge of coordinating the technical aspects of the project, including software development and planning, explains: Manchester has been the centre of innovation in the UK for centuries and is still today a region that encourages cutting-edge initiatives. Add to this fact that Manchester is not as large as London, makes is an easier location for getting to grips with problems on a practical basis. The fundamental system operations were already underway in Manchester, and the resident patient population already understood these operations. For example, the medical data for the Salford area was already completely in electronic form, and the clinical patient-search application, and participant data-collection service, which used those medical data, was also already in operation. This was of great advantage, when implementing further initiatives, and the regional residents who understood how medical services used their data, appreciated the benefits of such a system. This enabled us to significantly reduce the time it took to launch the project. GPs will be directly responsible for local healthcare in their areas, with representatives participating in the Clinical Commissioning Group (CCG). GPs will be entrusted with a majority of the NHS' healthcare services, and will be responsible for regional healthcare policy-making. One Hitachi Hitachi Limited and Hitachi Consulting signing an MoU with MAHSC and the NHS in Greater Manchester (April 2013) On the basis of discussions with partners over a six-month period, it was originally proposed that the integrated network of GPs should be expanded to cover about 2.87 million people in Greater Manchester and, at the same time, link up with all secondary care hospitals through a comprehensive data platform. As the Hitachi Group possessed these high quality resources, the team at Hitachi Consulting were confident that provided these resources were well integrated, and the plan was successfully executed, Hitachi as a whole would be able to add new value to the project. Mr. Zhang adds: In order to realize this goal, it was essential to Comments from partners in England: Raj Jain, Managing Director Greater Manchester Academic Health Science Network (GMAHSN) Manchester has some of the strongest health informatics capabilities found globally. We have the Farr Institute, NWeH, hospitals and primary care organisation who research, create and deploy truly innovative solutions with outstanding successes. Working with Hitachi has enhanced Manchester s capabilities as they have brought world class expertise coupled with practical know how that has resulted the opportunity for major advances in wellness and the prevention agenda. Their approach to partnership has been outstanding, and in particular their openness and commitment could not have been bettered Gary Leeming, Associate Director for Informatics, Greater Manchester Academic Health Science Network (GMAHSN) (previously) Chief Operating Officer, North West e-health (NWeH) Working with Hitachi has brought tremendous value for Manchester by attracting international investment in the city to develop a new type of partnership creating new concepts in electronic health. Through this partnership Manchester can access wider resource and experience than might otherwise be possible. Importantly it brings a world-leading industry partner to Manchester that has proven it has the vision to research and design the latest ideas in how healthcare could be delivered in the future. The opportunity to work with Hitachi also demonstrates Manchester s own capability and leadership in e-health across the world. Dr Linda Magee OBE, Business Development Director Manchester Academic Health Science Centre (MAHSC), & (also) Executive Director, Industry & Wealth, Greater Manchester Academic Health Science Network (GMAHSN) The NHS community in Greater Manchester, facilitated by Manchester Academic Health Science Centre and, more recently, by the Greater Manchester Academic Health Science Network, has a strategic partnership with Hitachi focused on the use of health data to improve healthcare across several development programs. Initial discussions began in September 2012 and a Memorandum of Understanding was in place by March In October 2013 Hitachi launched their European Big Data Lab in Manchester. A number of POC projects have also now been completed as we move to detailed project planning for the next phase of the program. The partnership operates across a complex set of organizations including NHS provider trusts, commissioners and the University of Manchester and key assets within that grouping, combined with recognition of communications across time zones and different languages. This has been challenging for all parties but the Hitachi team has demonstrated a very professional, dedicated and detailed approach to the partnership. They have provided excellent organizational support to the process, with a clear recognition of the limited resources of the public sector and time constraints for our senior leaders and clinicians, and taken the time to develop a strong understanding of how the local NHS system works. This approach has earned the trust and respect of all of us in Manchester for our Hitachi colleagues. About GMAHSN Greater Manchester Academic Health Science Network (GMAHSN) is a collaborative network of Greater Manchester, East Lancashire and East Cheshire NHS organisations, higher education institutes and industry. It is licensed by the UK s Department of Health with the ambition to deliver a step change in health outcomes and in how health expertise and spend can generate wealth for our local community. About MAHSC Manchester Academic Health Science Centre (MAHSC) is a partnership between The University of Manchester and six NHS organisations within Greater Manchester, uniting leading healthcare providers with worldclass academics and researchers. It is one of only six UK Department of Health accredited centres of excellence for translational medicine.

6 Steven Zhang was born in China, but grew up in Canada. He and Mr. Kumar were close friends since before joining Hitachi. He comments: NHS personnel, our partners, came to visit Hitachi in Japan, and I believe that this meeting greatly strengthened our relationship. For a manufacturing company to take on challenges such as the health insurance business and hospital management is revolutionary work, anywhere in the world. establish a data system and network infrastructure that take into account security and privacy, so that medical professionals could use it safely. For actual operations, it is necessary not only to incorporate new technologies, but also to ensure compliance with local laws and regulations. Hitachi Information and Telecommunication Systems Company, one of the main entities involved in the project, has the experience and expertise to undertake such operations, including building an integrated data-platform that ensures the anonymity of personalized medical data, and provides a secure data-access system across the board. For this, Hitachi brought on to the table its most up-to-date anonymisation technology, termed k-anonymity technology, developed at Hitachi s Yokohama Research Laboratory, and this was a critical component in the proper utilization and implementation of data security. Other initiatives, based on local issues, included a variety of service applications, such as lifestyle-improvement programs for people with high risk of diabetes, and a system with an intuitive UI that collates and presents a comprehensive history of patients prescribed medications and any related pathology results. The Mobile Health concept image - Smart devices for anytime access to personalized health data expertise of Hitachi s cloud-based health support service, called the Halsma Diet, developed at Hitachi s Central Research Laboratory with the aim of reducing visceral fat and encouraging clients to lead healthy lifestyles, was also included. These exemplar activities deliver a variety of applications, while protecting patients privacy, on a common platform, providing high-quality healthcare services to the residents of Greater Manchester, at the same time pushing the boundaries of innovation in health and wellness research. Another unique aspect of this activity has been the involvement of Hitachi s Design Headquarters and the important role they have played in developing Hitachi s application interface to be used by both medical practitioners and patients. Mr. Zhang explains: The Design Headquarters has contributed greatly to project design, including how to effectively communicate the vision, designing interfaces keeping users' experiences with the applications in mind. This design awareness is a major feature of this project. It was an unorthodox approach to designing solutions by focusing on how these services would affect the lives of people, whether at work or at home. This is exactly what it means to embark on a new project as One Hitachi. Naturally, there were challenges. Mr. Urakami describes these challenges: I think that in the past, one of the reasons why Japanese corporations, seeking to expand globally, were not readily accepted abroad was because of the organization of their marketing presentations. Using language such as "We have this" and "We can sell this" would not resonate with clients, regardless of how good the product might be. In order to appeal emotionally and practically, you need to find out what your business partners

7 the idea that began in October 2013, and has now entered the preparation stage for full-scale operation. Vision diagram for the Future of Patient-centric Healthcare are looking for - what they need - and to present a vision that resolves their issues. In that sense, the manner in which this project was managed was almost revolutionary for Hitachi. And as it was a highly novel approach, I think there was a great deal of anxiety amongst the participating members. There is a reason why the word partner is used here. Mr. Kumar recalls: Until now, it was the norm to talk about the dichotomy of us and the customer, but this way of thinking is the core behind the catalogue sales-type philosophy of most Japanese companies. In our case, we said that our would be customer was in fact our partner, with whom we should collaborate, share a common vision, and bring that vision to fruition, together. I kept drilling it in to everyone involved in the project to stop calling them our customer and refer to them as our partner, and while it was not easy to change behaviours overnight, I think we were at least able to set a strong precedent. This is a technology used to process data so as to prevent identification of individuals during subsequent use of data. Search results are processed so as to contain a predetermined amount (k) of data. This is a cutting-edge technology, with great further potential in the field of data utilization. Mr. Kumar notes: I consider the proof-of-concept stage to have been a success because we are all able to confirm that this concept will be of significant value. Going forward, we would like to take into consideration the opinions of medical practitioners in the field, and to make minor adjustments, to provide an even better system. Service development for the diabetes-prevention program has already begun, and a concrete business plan will be drawn up, showing the kinds of applications that will be running on the system. In addition to delivering actual services by means of this project, Hitachi intends to further promote its healthcare IT services business through lateral expansion. Mr. Urakami adds: A common reason for project failure is when only a platform or only an application is developed, and nothing more is done. Such initiatives are unlikely to be used on their own, but by offering both a data platform, and applications that sit on top of it, the level of utilization will increase. In this sense, we should be able to provide both wheels for this project. Based on the work in Manchester, we are now considering lateral expansion into other regions. I would like to see us expand across the UK, into the EU, and then throughout the whole world, all the while continuing to add value. Comments from Hitachi Design: Yukinobu Maruyama, Chief Designer Hitachi Design works on the design of many of Hitachi's tangible products and interfaces, however more recently we have been working with our group companies in designing intangibles like services and business models too. This project has been one of the front running exemplars of this shift. Hitachi Consulting along with having the insight into UK's health industry, had an in-depth understanding of the problems being faced by the stakeholders in the UK, and a clear grasp on Hitacih's vision and ideas for the future of their healthcare business. I feel this to be vital to their ability to help lead the Hitachi team as thought leaders, despite the unease around this project s very unorthodox service development process. The unique synergy between our user experience design methodology and their business consulting meant that we were able to not only design an experience driven solution, but also combine together in leveraging our group's technology assets to their maximum potential. Going forward, as we continue to develop service visions with other stakeholders, I hope we can continue to build upon this very strong partnership that we have developed between Hitachi Design and Hitachi Consulting. Hitachi s Healthcare IT Services Contributing to Preventive Medicine The Manchester Project has already succeeded in proving-theconcept, that is, a simple verification to show the feasibility of User feedback session as part of the PoC activity It is expected that the emphasis of healthcare in the 21st century will shift away from symptomatic treatment to preventive medicine. In this context, we will have to develop various applications in order to maintain people s health by preventing illness. Mr. Zhang mentions that: Currently, the Hitachi Group is working on initiatives such as algorithm development for long-term collection of chronological data, and for prediction of future illness, or for recording daily data that can eventually be used in remote healthcare. These types of next-generation healthcare applications will also probably be part of the platform in the future. Hitachi s healthcare IT service business, which had a jump-start in the England, will most likely continue to evolve and be deployed around the world. (Reporter: Madoka Tainaka; Photographer: Yuki Akiyama)

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