1. Connect, Engage and
Take Decisions
Opportunities and Challenges of Telemedicine
Implementation
Lars Kalfhaus | Oslo, 03. November 2014

2. The Market …
Now is the time!(?)
The Telemedicine Promise &
Challenges

3. The Market …

4. Telemedicine
eHealth
mHealth
mHealth = Telemedicine reloaded

5. Worldwide Market Size and Growth
(US$ millions)
research2guidance; March 2013

6. Main Professional and non-Professional Target Groups
research2guidance; March 2013

7. Market Potential by Therapeutic Area
research2guidance; March 2013

8. Market Potential revisited
Commissioner Tonio Borg, 04 April 2014
IDF, Diabetes Atlas 6th edition, 2013
Research2guidance; March 2013
Internal data
• mHealth market by
2017: €5,7 bn
• Preventable costs
from better chronic
disease management
and efficiency gains:
> €140 bn (in 2013)
€0,4 bn
mHealth Market
2013

9. Now is the time!(?)

10. Fundamental Global Trends
Josep Valor; IESE
Lars Kalfhaus (for QS)

11. Fundamental Global Trends - SOCIAL
SOCIAL

12. Fundamental Global Trends - SOCIAL

13. Fundamental Global Trends
- SOCIAL
250,000 members

14. Fundamental Global Trends - SOCIAL

15. Fundamental Global Trends
MOBILE

16. Fundamental Global Trends - MOBILE
Devices Regions

18. Fundamental Global Trends – BIG DATA
BIG DATA

19. Fundamental Global Trends – BIG DATA

20. Fundamental Global Trends – BIG DATA

21. Fundamental Global Trends – BIG DATA
US Department of Labour
Wipro Applying Thought

22. Fundamental Global Trends – QUANTIFIED SELF
QUANTIFIED SELF

23. Fundamental Global Trends – QUANTIFIED SELF

24. Fundamental Global Trends – QUANTIFIED SELF
Nothing new for people with diabetes!
With the
installed base of
medical devices
Today > 500.000
data points
This
Week
> 3.500.000
data points
… Norway

25. The Telemedicine
Promise & Challenges

26. No Significant Improvements in Diabetes Management
Diabetes
related drugs
and medical
devices
320 OADs
150 Insulins
10 GLPs
> 200 Med. Dev.
… despite access to and availability of
innovative pharmacological treatment options

27. Cost Burden as a Consequence of Suboptimal Diabetes
Management
Severe
x24
Moderate
Mild
General Population
x2
x6
Kaiser Permanente
Plan de Chronicos Navarra
• Promote health living,
prevention and good
health
• Avoid disease progression
and comorbidities
• Find adequate balance and
tools for integrating self-care
and professional care
Costs

28. The Promise of Telemedicine
Value = Health outcome
Cost of delivering the outcome
• Prevention
• Early detection
• Quality of Life
• Prevention of complications
• Less hospitalization
• Slower disease progression
• Faster recovery
• Fewer recurrences ...
… the enabling technology platform
Michael Porter; Redesigning Helathcare

29. Access, equity, quality
and cost effectiveness
Better health is the goal, not more
or less treatment
The Goal
Michael Porter; Redesigning Helathcare
Global Observatory for eHealth Series – Volume 2; who.int

30. Personalized Diabetes Management Cycle – Enabled by
Technology
Ceriello et al; Diabetes as a case study of chronic disease management with a personalized approach: the role of a
structured feedback loop; Diabetes Res Clin Pract. 2012 Oct

31. Key Considerations
… on the way to fully capture the Telemedicine promise
Organizational
Business Telemedicine Legal
Political

32. Business Considerations …
New Business Models needed
• Glocalization
• Interoperability
• Co-creation
• Integration
• Pricing and revenue
models

33. Organizational Considerations …
PWC – EIU; mHealth

34. Organizational Considerations …
• Process and cultural change on how care is
delivered
• Alignment of KPIs and incentive schemes for
healthcare workers
• Development and acceptance of new study
designs (beyond classical clinical evidence) to
assess effectiveness

35. Political Considerations …
• Willingness to engage in co-creation and overcome
classical barriers and role definitions between
stakeholders
• Build confidence and trust between all stakeholders
• Coherent policy making that encourages competition
centered around patient value over the entire care
cycle

36. Legal Considerations …
… technology changes faster than legal
and regulatory framework
• Data protection, patient safety and privacy is a top priority
• Regulatory aspects: Medical Devices (classes) boundary
between MD and non regulated products – interoperability
between the two
Changes in contractual framework especially public sector
procurement and tender legislation

37. To Sum Up …
• The business potential of Telemedicine could be far
greater than generally estimated
• It will require (and enable) fundamental
restructuring of healthcare delivery
• Co-creating and collaboration between stakeholders
will be key in a value-creation approach on what the
technology should accomplish