The third place: health care everywhere HBA 2012 Leadership Conference Enlighten Empower Evolve Carolyn Buck Luce Ernst & Young Life Sciences Leader Emerita HBA 2012 Woman of the Year
Agenda The third place: health care everywhere Patients: nudging patient behavior Business models: creative disruption The ecosystem: aligning for impact Be the change: Finding the leader within
Pharma 3.0 From pharma s perspective Drivers of change R&D productivity Patent cliff Globalization Demographics Pricing & reimbursement Health care reform Health IT Consumerism Value mining Business Models Value proposition Pharma 1.0 Blockbuster drugs Pharma 2.0 Diversified drug portfolios Pharma 3.0 Healthy outcomes Customer Physician Payor Patient
Pharma 3.0 the shift from products to health outcomes Business Model Pharma 2.0 Diversified product portfolio Product-centric; B2B Pharma 3.0 Health outcomes Customer-centric; B2C Value Drivers Revenue/Margins Health outcomes for patients Brand Value Product Efficacy Customer Experience Go-to-market strategy Pitching Listening and co-creating Inorganic Growth Innovation Information Acquisition of product Companies Product Development Approval based on clinical trial data Innovative partnerships Development of new businesses and markets Reimbursement based on real market effectiveness
Health care costs World population over 65 Drivers of health outcomes Chronic disease 75% 0.5 b 1.5 b Behavior 50% 2010 2050 The single biggest opportunity for improving health outcomes is Behavioural change
Promise of personalized medicine, requires interventions addressing the value leakages resulting from clinical, social and behavioral gaps in the patient care pathway Women are generally regarded as caregivers and often neglect their health to take care of family Social stigma of diseases Cost burden Lack of insurance Misaligned incentive among physicians Lack of proactive selfhealth management, motivation and low awareness about diseases Poor diagnosis due to asymptomatic nature of diseases and lack of appropriate diagnostic tools
Today, health care is delivered in two places Periodic measurement Treatment of disease Rx Annual physical Diagnosis Doctor s office Results Opaque Providers have control Wait to hear Lab tests Inpatient care Hospital
Welcome to the third place The third place is the patient Periodic measurement Smartphone apps Social media Continuous monitoring Treatment of disease Opaque Medicalized consumer devices RT monitoring, prevention Sensor data Insights, feedback Telehealth Providers Prevention, behavior Transparent Providers have control Consumerized medical devices Data, control Remote care Caregivers, other HCPs Patients have control
60 seconds in Social Media 1090 Visitors 2083 3125 3500 Check-ins Photos uploaded New friend connections 7610 searches 7630 stumbles 175,000 tweets 700,000 messages sent 20,00,000 videos viewed; 48 hours of content uploaded
The Third Place healthcare everywhere Drivers and opportunities Growth opportunities Payor New business models Physician Hospital Less pricing pressures New sources of revenue Customer-driven innovation New approaches to R&D Treatment Diagnosis Health management Prevention Predisposition testing Changing economic incentives Changing Technologies Changing the game Payment reform Holistic care Smartphone apps Sensors and monitors Social media Efficient resource usage Transparency Coordination and prevention Increased access Personalization everywhere
A Forth Space Source: The Digital Dimension of Healthcare: Report of the Digital Innovation in Healthcare Working Group 2012
Patients: nudging patient behavior
Are We are we rational? irrational but predictably so Opt-out organ donation = A donut today Displeasure from losing $100 > Opt-in organ donation A longer, healthier life Pleasure from gaining $100 and the predictability of our biases means that we can correct for them
Gaps in patient behaviors Processing information Problem: big data, complex data Solution: relevant, neutral information based on individual circumstances Personalized to circumstances Made relevant Information on choices and trade-offs Patient Resisting temptation Problem: hot states vs. cold states Solution: Technologies to manage behaviors in hot states Social networks for feedback and reinforcement Gamification to create motivation Contracts to lock in behaviors
Embedding Incentives to Change Behavior Examples from the front lines HealthPrize Startup using multiple behavioral economics levers to improve drug adherence GymPact Startup using behavioral economics principles (loss aversion, hyperbolic time discounting, status quo) and mobile technologies to motivate people to exercise regularly HumanaVitality Get Active! by Aetna FriendFit Nike+ DailyFeats Pfizer/Keas JV between Humana and Discovery Holdings that uses points, prizes and other gamification levers to motivate healthy behaviors Initiative that uses allows employees at a company to form teams aimed at fitness and healthyeating goals Website that allows users to share fitness activities on social media sites and motivate each other Products that motivate users with real-time feedback on exercise (e.g., wearable sensors to track activity levels, integration with smartphone apps) Motivates users to achieve health-related and other goals through reminders, incentives feedback from social media friends, etc. Collaboration on Keas platform to develop personalized online care plans for users. Keas website motivates employees with points, badges, and feedback from co-workers.
General population Personalized medicine Sciences of medicine and behavioural economics At risk Diagnosed patient Treatment Monitoring Relapse Molecular diagnostics, biomarkers Targeted therapeutics Behaviors Dx Rx Dx Adherence Behavioral levers diet, exercise, smoking, etc. Neutrally-framed info include patient preferences Real-time monitoring, behavioral levers Behavioral levers adherence
Business models: creative disruption
The business model canvas Business model canvas Key partners Key activities Value propositions Customer relationships Customer segments Create value Key resources Deliver value Channels Cost structure Revenue streams Capture value
Creative disruption Apple s revenues over time
Business models for the third place Datacentric Behaviorally savvy Experiencefocused Harnessing and monetizing insights from data Leveraging behavioral economics to succeed in the behavioral change business Focusing on mass customization and industrial design to enhance the patient experience Holistic Encompassing the cycle of care and the lifecycle of the patient Revenue-flexible Identifying innovative ways of capturing value
The ecosystem: aligning for impact
A virtuous circle of innovation
Be the change: finding the leader within
Start with the right question You can HAVE it all You just can t DO it all What is IT?
Centered leadership model from McKinsey
Women and power the challenge for women The Challenge The Good Girl problem The Goldilocks syndrome Embracing ambition Finding your purpose Using power intentionally
Finding the Courage to Lead Declare your purpose Claim ambition Construct your Ten Year Plan Networks and Networking Personal Brand Get digital and own your identity Board of Directors
Build Ambition Mastery Recognition Ambition Critical Experiences Knowledge Relationships Networks
The Ten Year Plan Your Philosophy and Purpose Why are you on the planet? Your Strategy - Ten Year Destination How will you be known in the world? Your Tactics - Domains of Mastery Levels 1-10 Your Foundation Friends, Family and Faith
Networks are the Engine of the 21rst Century
Get digital!
Building Your Personal Brand Purpose Passion Power Position Persona Platform
Build Your Own Virtual Company Sponsors Mentors Strategic Alliances Key Opinion Leaders Followers Board of Directors
Connecting the Dots: Winning at Home, at Work and in the World
Ernst & Young Assurance Tax Transactions Advisory About Ernst & Young Ernst & Young is a global leader in assurance, tax, transaction and advisory services. Worldwide, our 152,000 people are united by our shared values and an unwavering commitment to quality. We make a difference by helping our people, our clients and our wider communities achieve their potential. Ernst & Young refers to the global organization of member firms of Ernst & Young Global Limited, each of which is a separate legal entity. Ernst & Young Global Limited, a UK company limited by guarantee, does not provide services to clients. For more information about our organization, please visit www.ey.com. 2012 EYGM Limited. All Rights Reserved. 1207-1376235