Connected Health Latin American Perspective. 4 th March 2015

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Mercy Bradley
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1 Connected Health Latin American Perspective 4 th March 2015

2 Latin-American Connected Health Part 1 Overview

3 Connected Health in LatAm Introduction

of ICT in the Health Sector; 2005/06 IADB study of ICT investments for

4 Connected Health in LatAm Past Experiences: Sources of Information 2004 Telehealth in The Americas OAS, ITU, PAHO; 2005 ITU study on the impact of ICT in the Health Sector; 2005/06 IADB study of ICT investments for the Health Sector in the Hemisphere; 2007/15 Literature and Conferences

5 Connected Health in LatAm Past Experiences: The Main Issue is Sustainability Maturity Stakeholders Pioneering Projects Telediagnose Decision Support Continuous Education Pilot Projects Decision Support Continuous Education Implemented Projects and Programs Second Opion Universities Non Profit Organizations Governments National / Federal Local Corporations ICT industry Health Industry

6 Connected Health in LatAm State of the Art s Overview On-Going and/or in preparation Telemedicine and Telehealth Projects in 20 of the 34 OAS countries National Public Authorities Regional Iniciatives & Forums

7 Latin-American Connected Health Part 2 Chile s Experience

8 Chile Health Market Players

9 Connected Health in Chile From a historical perspective to On-going programs Chile s Connected Health Piloting ( ) Public Projects & Programs Tele-EKG Tele-Dermatology Tele-Radiology Virtual Presence (Telediagnose) Private Initiatives Pontifica Universidad Católica Universidad de Chile (CHUCh)

10 Chronic Disease Context

11 A Compelling Proposal for Health Insurers Lack of control over chronic patients generates 120k avoidable hospitalizations per year Chronic diseases are critical component of Insurer s medical losses Other Chronic ~30% Source: Estimation based on the Encuesta Nacional de Salud 2010, Ministerio de Salud, Chile and ACG pilot 2012 Experience shows tele-monitoring can reduce expenditures by up to 60% Expenditure is disproportionately concentrated in more complex patients 30% 20% 10% 0% RUB5 # Patients Expenditure Source: Chile Ministry of Health (Pilot Project ACG 2012), Company estimations Large opportunity size of chronic patients (number of patients, millions) Diabetes prevalence Hypertension prevalence Reference cost per patient Final cost per patient Source: US Department of Veterans Affairs, Care Coordination/Health Program Source: Encuesta Nacional de Salud 2003, 2010, Ministerio de Salud, Chile

12 Telemonitoring Chronic Disease s Virtuous Circle Expense per patient Without Telemonitoring With Telemonitoring follows a tendency with incremental Expense per Patient ($) Expense per Patient ($) Potential Savings peaks at decompensations Telemonitoring minimizes decompensations and softens disease tendency Year 1 Year 2 Year 3 Year 4 Year 5 Decompensation Peak Year 1 Year 2 Year 3 Year 4 Year 5 Decompensation Peak

13 Chilean Evidence Base Effectiveness Literature shows strong evidence of disease risk reduction associated with metabolic control Our results have proven a significant reduction of the Disease Indicator Data: SSMS Public Health Chronic Disease Telemonitoring Program 1% decrease in Disease Indicator levels reduces disease risk in: 0% 10% 20% 30% 40% 50% Microvascular Disease Periferic Vascular Disease Myocardial Infarction CVA Heart Failure Cataract Extraction Diabetes-Related Death The economic impact of a reduction in the Disease Indicator can be inferred from the results of a study conducted over patients, published in the British Medical Journal (BMJ) Source: Adapted from Stratton IM, et al. BMJ. 2000;321: Before Telemonitoring 10,4% 8,6% After Telemonitoring CRS El Pino CESFAM Joan Alsina Clinical results shown significant reductions on patients Disease Indicator (i.e. glycosylated hemoglobin) 10,3% 8,8% -1,8-1,5 Note: Patients with medium-high complexity (CRS El Pino) and patients with low-medium complexity (CESFAM Joan Alsina)

AccuHealth s business model breaks the Zero Sum paradigm that negatively affects the Health Industry Business Model Business models Follow a 4 Win vision Patients Life quality improvements Better

14 AccuHealth s business model breaks the Zero Sum paradigm that negatively affects the Health Industry Business Model Business models Follow a 4 Win vision Patients Life quality improvements Better access to medical care Greater efficiency Humanized environment Greater outreach to patients Greater monitor frequency Improve patient s support perception Reduce unnecessary hospitalizations Medical doctors Insurers (Isapres and Fonasa) Control medical loss ratios Improve service offer Better control of patient s health Greater customer satisfaction Increase hospitalization bed turnover Focus on higher complexity care Optimize resources allocation and empowers talent Service Providers (Hospitals and Clinics) Pricing Models: Results +++ with Savings Share with the Private Sector

15 Thank You

Telemedicine - a challenge rather than solution for payers and service providers in EU

Telemedicine - a challenge rather than solution for payers and service providers in EU K. Dziadek, MAHTA G. Waligora Keywords: adherence, e-health, telemedicine, telemonitoring DOI: 10.7365 / JHPOR.2015.1.1