Identification of the participant

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1 Identification of the participant Participant Name: Daniel Ferreira Polónia Academic Degree: PhD Academic Institution: Universidade de Aveiro/Aveiro University Academic Course: Engenharia Electrotécnica/Electrotechnical Engineering Thesis Title: Mercado Electrónico para Serviços de Teleradiologia/Electronic marketplace for teleradiology services Thesis Supervisor: Prof. Doutor Manuel Oliveira Duarte/Prof. Doutor José Luís Guimarães Oliveira Current Thesis Status: Officially concluded Thesis Final Grade: Approved 1

2 Problem identification (1/2) Challenges and trends in teleradiology Historical Perspective Lack of integration Information Systems Recent Development s Present Situation Stagnant number of radiologists More images produced Evolution Trends Limits for integration IHE, R-Bay Prevents teleradiology Deeper integration of the IS Enhanced productivity More agile interpretation process Trans-European markets in healthcare (/24/EU) Quality of the services provided in outsourceing Evaluate and manage quality of the service provided Vs. Desintegrate the workflow Commoditization of the image interpretation process Single european healthcare services market with imaging setting the pace? Can we detach the referrer from the radiologist in all cases? 2

3 Problem identification (2/2) Status quo in Portugal 3

4 Main solution to problem Imaging Marketplace 4

5 Main solution to problem Imaging Marketplace 5

6 Main solution to problem Possible solutions st st st st st st st st st st st st 6

7 Main solution to problem Imaging Marketplace 7

8 Main solution to problem Imaging Marketplace st st st st st st st st st st st st 8

9 Main solution to problem Imaging Marketplace st st st st st st st st st st st st 9

10 st 1 st 1 st 1 st st st st k st k n Financial M gment Technologic al M gment BROKER Broker Broker Evaluator l Evaluator l st k n n Evaluator l

11 st 1 st 1 st 1 st st st st k st k st k n Financial M gment Technologic al M gment Reverse auction criteria: Price; Rad qualification; Time. BROKER Broker A B Broker Evaluator l n n Evaluator l Evaluator l C D E 1. E k

12 st 1 st 1 st 1 st st st st j st j st j n Financial M gment Reverse auction: Lowest bidder wins. Technologic al M gment BROKER Broker E 1 Broker Evaluator l Evaluator l E j n n Evaluator l E z

13 st 1 Reverse auction: Winner receives study; Technologic Performs interpretation al M gment Financial M gment st 1 st 1 BROKER Broker st Evaluator l n Broker st st st j st j st j F Evaluator l Evaluator l n n

14 st 1 st 1 st 1 st st st st j st j st j n Financial M gment Work finished on time: Returned to Technologic al M gment BROKER Broker Broker Evaluator l Evaluator l G n n Evaluator l H

15 st 1 st 1 st 1 st st st st j st j n Financial M gment Technologic al M gment BROKER receives work: If it accepts Payment processed; Broker If it rejects Sends to evaluator for second opinion. Broker Evaluator l n n Evaluator l Evaluator l st j I H J

16 Main solution to problem Imaging Marketplace Pros Cons Balance Availability Interconnection between all institutions and all professionals Positive Costs Reduction through bidding Exam dematerizalization Cost to design, implement, operate and maintain the system Positive Process Enhancement Reduce duplicate exams Rational equipment use Speedier interpretation Positive Satisfaction Choose the most suitable radiologist, fitting the exam to the interpreter Positive (with the possible 16 exception of the radiologists)

17 Relevant audience According to Osterwalder s canvas business model Partnerships for communica on management Partnerships for broker data center management Management of evalua ng and appeal teams Auc on processes Appeal processes Evalua on processes Access to radiology care Swi er interpreta on of the images Enhanced pa ent treatment Financial self sufficiency of the system Enhanced produc vity Risk reduc on on the acquisi on of image interpreta on Help desk sts General Prac oners Healthcare financing ins tu ons (public and private) Broker pla orm management Expert panel Market regula on en es Only web based communica on channels So ware pla orm available to the users Hardware/So ware pla orm where data centre is based Communica on infrastructure, interconnec ng users and data centre Back up and redundant systems One me revenues Recurring revenues Appeals and penal es for service level agreement unfulfil ent Classifica on review of the selling radiologists Users system integra on and technical help desk service 17

18 BIZZ POOL One time revenue and Recurring fees from s Regulator/Manager One time revenue and Recurring fees from sts BUYER POOL n BROKER BROKER SELLER POOL st k Patient Financer o Evaluator l Financer EVALUATOR POOL

19 Sends exam to be auctioned in the broker with start price equal to co-payment to be paid by Patient BIZZ POOL Regulator/Manager Wins the auction, with a discount δ (the largest difference between start and end price in auction) BUYER POOL n BROKER BROKER SELLER POOL st k Patient Financer o Evaluator l Financer EVALUATOR POOL

20 Evaluator l EVALUATOR POOL BIZZ POOL Regulator/Manager Sends δ (equal to the difference between auction start and end price) BUYER POOL n BROKER BROKER SELLER POOL st k Patient Financer o Sends value (co-payment δ), equal to final price of the auction 100% co-payment to the system financing entity Financer

21 BIZZ POOL δ*α = Broker financing With α + β + γ + ε = 1 and η between 0 e 1 Regulator/Manager BUYER POOL n δ*γ = revenue BROKER BROKER SELLER POOL st k δ*β = st revenue Patient Financer o δ*ε = Financer revenue Evaluator l δ*ε*η = Patient reimbursement Financer EVALUATOR POOL

22 Value proposition According to Osterwalder s canvas business model The implementation of the proposed system (currently implemented as a prototype) will: Improve accessibility to radiological services by the population; Improve speed and reduce costs involved in processing the radiological images; Reduce risks involved in the acquisition of imaging interpretation services; Optimize imaging equipment productivity; Enable, through a benefit redistribution among the participants, the financial self-sufficiency of the system. 22

23 Future work Improve auctioning mechanism according to the requirements of the end users, namely optimizing the submission process from a one-by-one submission to an en masse submission process Improve system scalability when subject to the use by a large number of customers; Create a single user repository at European level, enabling the requirements of the Cross Border Healthcare Directive /24; Implement the business plan attached to the thesis, managing the marketplace during 5 years. Very conservative approach Expected NPV Expected IRR 10,18% 23

24 Backup Slides 24

25 Business plan 25

26 Business plan População Médicos Médicos não especializados Especialistas em Radiodiagnóstico Exames leiloados (total) Médicos clinica geral aderentes Angiografia Penetração Ecografia 5,45% 8,06% 19,50% ,38% ,12% stas aderentes Exames radiológicos Penetração Mamografia 5,45% 8,06% 19,50% ,38% ,12% Ressonância magnética Tomografia axial computorizada ( Outra Exames leiloados (Publico) Angiografia Ecografia Exames radiológicos Mamografia Ressonância magnética Tomografia axial computorizada ( Outra Penetração Internamento/Urgência 0,00% 0,00% 0,00% 0,00% 0,00% Penetração Externo/Consulta Externa 2,32% 4,18% 12,36% 22,98% 26,37% Exames leiloados (Privado) Angiografia Ecografia Exames radiológicos Mamografia Ressonância magnética Tomografia axial computorizada ( Outra Penetração Internamento/Urgência 2,32% 4,18% 12,36% 22,98% 26,37% Penetração Externo/Consulta Externa 2,32% 4,18% 12,36% 22,98% 26,37% 26

27 Business plan 27

28 Business plan 28

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