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Growth and Innovation in the Healthcare
Industry
Trends, Opportunities, and Challenges
January 17, 2014
2
Healthcare—What Survey Participants Identified as Hot Topics
Rank Market Topic % of Respondents Nominating as
Hottest Topic
1 Mobility in Healthcare/mHealth 51%
2 Cloud in Healthcare: Current Issues 45%
3 Regulatory Environments 44%
4 Cancer Market Outlook 39%
5 Remote Monitoring 38%
6 Drug Delivery Market 35%
7 Patient and Consumer Engagement 32%
8 Healthcare Dashboards 31%
9 Electronic Health Records/Electronic Medical Records 31%
10 Growth Drivers Impacting the Medical Devices Segments 30%
11 Drug Discovery Research Outsourcing Market 28%
12
Homecare Market Trends - Demand, Addressable Segments, Infrastructure,
and Policy
25%
13 Video Telemedicine 24%
14 Cardiovascular Therapeutics - Dyslipidemia/CHD Prevention 24%
15
Changing Profiles of Influencers and Decision-makers Impacting Medical
Device Choice
22%
Healthcare: Identification of Hot Topics, Global, 2013
Source: Frost & Sullivan
3
Healthcare Policy Issues Addressing Quality, Access, Cost
Incentive
payments
Telehealth
At-Risk
Contracting
• Population health
management
• Patient Empowerment
Moving the needle gets
harder
4
Telehealth and mHealth
5
Telehealth Industry—Percent Revenue Forecast by Vertical
Market
Note: All figures are rounded. The base year is 2012. Source: Frost & Sullivan analysis.
Key Takeaway: Remote monitoring is the oldest and largest of the three subsegments, with sizable
contributions from both the professional and consumer sectors
Remote
Monitoring
71.1%
Video
Telemedicine
11.4%
mHealth
17.5%
Telehealth Industry: Percent Revenue Forecast by
Vertical Market, North America, 2012
Note: Does not include general infrastructure or
managed services
Market Revenue, 2012
$2.39 Billion
$280M 2012
$430M 2012
$1.74B 2012
6
Consumers Believe mHealth Will Improve Convenience,
Quality, and Cost
Source: The Economist Intelligence Unit (2012 ) and PWC: Emerging mHealth: Paths for Growth (2013) and Frost & Sullivan
Surveys of consumers show an increasing interest and enthusiasm for using mobile devices to
engage with healthcare providers
In the next three years, patients agree that…
52% 48% 46%
mHealth
applications /
services will
make
healthcare
substantially
more
convenient
for me
mHealth
applications /
services will
improve the
quality of
healthcare I
receive
mHealth
applications /
services will
substantially
reduce my
overall
healthcare
costs
Top drivers for patients to begin using or
increase using mHealth -
Ability to access by my
healthcare providers more
conveniently/effectively
Ability to reduce my own
healthcare costs
Ability to take greater control of
my health
Ability to obtain information that
is difficult or impossible for me to
obtain from other sources
Ability to access better
quality healthcare
46%
43%
32%
28%
25%
7
Which Telehealth Markets Will Have the Highest Impact on
Healthcare Industry?
Home Healthcare and Disease Management
Base: Telehealth Respondents (ATA 2013; N=63)
Q. Please rate the following telehealth markets on their level of overall impact for healthcare industry over the next five years.
Remote Physician / Specialist Services
Telemental Health
Video Diagnostic Teleconsultation
93%
91%
73%
66%
Current
Opportunity
Short Term
Growth
Long Term
Growth
Transformative
Potential
Best Business
Models
Industry Sector
% Rating High +
Very High Impact
8
mHealth The Most Likely Additions To Telehealth Services
Base: Telehealth User responses (ATA 2012; N=83); Note: Multiple Mention Response
Q. What telehealth service are you looking to add in the next 3 years? (check all that apply)
*Other Selection was a write in answer.
Users’ Responses Regarding the Most Likely Additions To Their Telehealth Services,
North America, 2012–2015
12%
8%
12%
10%
7%
4%
10%
10%
23%
5%
0% 5% 10% 15% 20% 25%
Post-discharge Remote…
Telecardiology
Telemental Health
Telestroke/Neurology
Telenursing
Teleimaging
Telerehabilitation
Remote Consultation (Non-specialist…
mHealth
Other Selection*
User Response
Source: Frost & Sullivan.
9
Next Steps for mHealth
Adoption
 Personal devices
 Professional solutions
Regulation
 FDA guidance finally released
 Impact to date on funding
Business model success
 Waiting for reimbursement?
 Will ACOs be the tipping point?
 Sustainable consumer models?
Value
 Clinical efficacy still unproven?
 Long term value to individuals?
10
Adoption and Impact of Cloud Technology
11
Confluence of Change in HC Driving Shift Toward the Cloud
Data creation and storage
Targeted Care Prevention
Cost Control HC Innovation
Information sharing
Information access
Costs
Impact of genomic data
12
Confluence of Change in HC Driving Shift Toward the Cloud
Data creation and storage
Targeted Care Prevention
Cost Control HC Innovation
Information sharing
Information access
Costs
Deployment speed
Scalability
HCIT personnel shortages
Impact of genomic data
Data silos
13
Cloud Solutions Are Aligned With Healthcare Shifts
Source: Frost & Sullivan analysis
Big Data Mobility
Cloud
Social
Media
Cloud allows scale in
storing big data
Collaboration in research
means moving partners
to the data
Care collaboration and
transitions in care
require flexible access
and merged data sets
Cloud is a key enabler
of mobilizing data for
use by consumers and
enterprise users Point of Care PatientLab
Genomics
Care Coordination
14
Healthcare Transformation Will Require Shared Access
Source: Frost & Sullivan analysis
“Within ___ years, it will be considered
malpractice to treat a patient without
consideration of their individual –omics data”
Not if, but when…
With 5,400 petabytes of raw data from next generation
sequencing to be stored by 2018, cost effectively storing and
making this data accessible to clinicians and researchers will
require cloud solutions
15
Cloud Solutions Can Help Address HCIT Challenges
We are creating
millions of
useful data
points,
from a wide
variety of
sources…
DATA  INTEGRATION  ANALYTICS  ACTION
…But the data is
provided in
separate
solutions which
prevent getting a
holistic view of
the patient
Predictive
analytics has
arrived…Natural
language
processing will
become a
commodity…
,,,But working
with only part of
the data
Analytics alone
cannot drive
process change.
Analytics ideally
need to create
actions, with
prompts and
information
embedded in
workflows
(not in stand-
alone platforms)
16
Trust Among Consumers
74% of patients are comfortable having
their health records available in the
cloud, assuming adequate security
(excluding Germany and Japan)
According to a recent survey of 6,000 people in 10 countries
(sponsored by Cisco)
Consumers view benefits as outweighing costs or risks of
storing health information in the cloud – at least to the degree
they understand the risks
17
Big Data…Briefly
18
Leveraging Big Data To Reduce Healthcare Costs
NaturalLanguageProcessing
Biometric
sensors
19
Types of Analytics Applied in Healthcare Big Data Solutions
What Happened?
MoreTraditional
HealthcareAnalytics
PREDICTIVE
ANALYTICS
COMPARATIVE
ANALYTICS
PRESCRIPTIVE
ANALYTICS
DESCRIPTIVE
ANALYTICS
What Will Happen?
NewAnalyticsTools
NeededByACOs
Source: Frost & Sullivan
20
Vendor Consolidation, Startups and Large IT Market Entrants
Software, Platform, Integration, Customization, Consulting, Services
21
Opportunities to Leverage Big Data
Source: Frost & Sullivan
Clinical Decision
Support (Accelerate
dissemination of
research findings)
Individualization of
Treatment and
Interaction
Comparative
Effectiveness and
Outcomes Research
Clinical Trial Design
Microsegmentation
of Cohorts and
Consumers
Direct-to-Consumer
Analytics
New Data Sets, New Tools, New Business Models
22
Consumer Engagement
23
Consumerization
Behavioral economics
Quantified self
Increased
individual financial
responsibility
Social networks and online health resources
Source: Frost & Sullivan
24
Patients Bring A Consumer Mindset To Healthcare
Interactions
Consumer
Expectations
 24 / 7 / 365 support via phone, chat, etc.
 Direct outreach to consumers based on consumer preferences
 One stop resolution or call backSource: Frost & Sullivan.
• Customer service focus
• Comparison shopping
• Self-service, online shopping
• Special offers
• Proactive outreach to stimulate consumer response
• One stop shop
• Anytime, anywhere service
Entertainment, Media, &
Telecommunications
Transportation & Distribution
Retail & Finance
• Customized products
• At-home service
• Variety
• Engaging interface
 Ability to control and customize
 Flexibility and convenience
 Anytime, anywhere options
 Real time info at point of use
 Info comes to consumer
 High levels of interaction and Q&A
online and in person
“We have not been able to accelerate to that next level of providing that customer
experience that people come to expect when interfacing with a hotel or other industry”
25
What Are Consumers Looking For From Healthcare
Engagement?
• Breaking down “bricks and
mortar” approach to healthcare
• 24/7 access to personal health
information via web portal
• Ability to communicate with
providers via email
• Test results and other data
delivered via mobile devices
• Online scheduling and bill pay
• E-visits
 Convenience
Engagement
Personalization
• Preference-based care
vs. evidence-based
care
• Customized approach
to communication
• “Respect my wishes for
privacy and security”
• Clear explanations of condition
• Content to help patients
understand health status
• Shared-decision making
• “In the loop” – treat patient like
a member of the healthcare
team
• “I want all my information in one
place so my community has
access”
Source: Frost & Sullivan
26
Social Networks: Where Patients Are Empowered
Patients flock to sites to share
experiences and learn from others
with similar conditions
What do people discuss online regarding
health conditions?
• Symptoms
• Treatment options
• Medications, side effects, etc.
• Doctor-patient interaction
• Emotional support
What health conditions are discussed?
• Breast cancer
• Depression
• Bipolar disorder
• Arthritis
• Cardiovascular disease
• Fibromyalgia
• Alzheimer’s disease
Source: NM Incite, Frost & Sullivan analysis.
27
Consumer Attitudes Towards Care Delivery Are Changing
76% of patients say access to care is more
important than physical human contact
with their care provider
70% of patients would trust an automated
device to provide a diagnosis and
determine whether or not they needed
to see a doctor
According to a recent survey of 6,000 people in 10 countries (sponsored by Cisco)
87% of patients would trade off time, money
and/or convenience to be treated at a
perceived leading healthcare provider,
and gain access to trusted care and
expertise
28
Two Views of the Provider–Patient Relationship
Information giving
Authoritarian (parent-child)
Dictated behavior
Compliance
Resistance is bad
Persuade, Manipulate
Information exchange
Shared decision making, Cooperation
Negotiated behavior
Adherence
Resistance is information
Understand, Adjust, Accept
We save the patient Patient saves themselves
Practitioner centered Patient centered
Source: Steve Basiago, Walgreens Health Services
29
Multi-Channel Approaches Add Value In Patient Engagement
IVRText EmailVoice
Report
Data
Self
Service
Inbound Outbound
At-Risk Motivate
Quality
Measures
Educate
Live
Agent
ChatVideo
• More interactions
• More often
• Engagement more critical
• Personalization in interaction
• Approach depends on engagement goal
• Automate, escalate, engage
Patient experience changes over time:
optimism, acceptance, knowledge,
social support, etc.
Source: Frost & Sullivan
30
Opportunities to Address Empowered Patients
• Consumer is addicted to repairative care  Value of preventative care not sold
• Health literacy is low, anxiety regarding diagnosis
• Not just data, what’s the meaning
• Information provided like a financial statement
• Here’s where you started the month...this month’s activities...here’s where you are now
Gaming,
Rewards,
Motivation
Combine patients
to create
consumer power
Content that is
individualized +
personalized
Network,
Collaborate
Source: Frost & Sullivan analysis.
Patient
ownership
of data
Research and market
products designed for
specific types of patients
Direct-to-
consumer
analytics
Packaged episode of
care bundle, customized
and purchased online
31
Medical Device Connectivity
32
Interoperability Platform
Medical
Device
Connectivity
Oximeter
Infusion Pumps
Monitors
Electronic Medical Record
Workstation
Medication
Station
Smart phone or tablet
Other Diagnostic
Devices or
Biometric Sensors
Point-to point Connectivity enables Standardized Electronic Records, Remote Healthcare and
Diagnostics, Remote Clinical Care, Electronic Medical Records, and Mobile Healthcare.
33
Key Configuration Considerations
Categorizing
Devices
System
Deployment
Patient association is critical to effective implementation of connectivity solutions.
Initiation can either be patient centric or location centric. Ensuring tracking across
the worflow and proper patient disassociation is of equal importance.
Categorization of devices based on use and data transmission. Episodic devices
obtain a single set of measurements at a fixed time. Continuous tracking devices,
are continuously capturing data and device performance information, some are
stand alone while others can transmit across an enterprise network.
Deployment is tied to how the device fits in the clinical workflow. Does it require
a point of care component, or is central station monitoring sufficient.
Patient
Association
Synchronized time stamping, security from malware, downtime protocols, and
integration of data with an EMR are among the most challenging issues to
adoption of interoperability systems.
Data Validation
and Security
Protocols for change management as devices get replaced or upgraded are
important to factor into the network, and consider contingencies of how changes to
one might affect another. It requires coordination from both institutions and OEM’s..
Change
Management
34
Spheres of Influence Lack Alignment
Key Supporting Organizations
Supporting
Organizations for
Interoperable HC
Systems
Clinicians
Patients
Professionals in
leading HC
Organizations
System Safety
Experts
Manufacturing
Representatives
Standards
Setting
Organizations
Regulatory
Bodies
Research &
Academic
Institutions
Patient Safety
Advocates
Payers
35
Available Third Party Solutions – Qualcomm Life
• With the acquisition of Healthy Circles and investment in PracticeFusion, Qualcomm Life
is expanding capabilities for data integration and potentially analytics
36
Available Third Party Solutions- Netspective Fluent M2M
37
Available Third Party Solutions – iSirona and Capsule
Technologies
38
ECRI Use Case Analysis - Vendor Comparison Automated
Documentation from a Ventilator
39
Healthcare Market Outlook
40
Personalization, Communication, Decentralization, Collaboration
Personalized/Precision Medicine
Patient Centric
Decentralized, Community-based
Collaborative, Shared Information
Based on Protocols and Analytics
Preventing Sickness (Wellness)
Integrated, Two Way
From...
One Size Fits All
Provider Centric
Centralized, Hospital-based
Fragmented, Specialized
Based on Individual Expert
Treating Sickness
Fragmented, One-way INFORMATION FLOW
LOCATION
FOCUS
APPROACH
TREATMENT
DECISION MAKING
OBJECTIVE
...To
Procedure-based Bundled, CapitatedREIMBURSEMENT
Source: Frost & Sullivan
41
Care Delivery Transformation: From Acute Care to Prevention
Track, Predict, Intervene, Manage
Disease/Care
Management
Prevention/Wellness
Goal:
Keep
People
Healthy
Longer Goal:
Manage
or Mitigate
Risk Goal:
Diagnose
and
Reduce
Treatment
Delay
Goal:
Manage Goal:
Quality of
Life
Goal:
Move to
More
Interaction
and Self-
Mgmt
Healthy/
“Worried Well”
“At Risk” Undiagnosed Chronically Ill
Managed
Chronically Ill
Unmanaged
End
of Life
Continuum of Care
SizeofImpactedPopulation
$$
•Early identification and prevention
•New models of care delivery to improve:
•collaboration among providers
•patient knowledge, self-help and health
•Increase intervention
•Higher touch at lower cost
Source: Frost & Sullivan
42
Last Decade Current Decade Next Decade
Types of
Companies
Market
Dynamics
Main Focus
Revenue
Pharmaceuticals—Business Outlook
Approximately $328 billion (pharma)
(total drugs market - $353 billion)
Approximately $766 billion (pharma)
(total drugs market - $830 billion)
Approximately $1,350
billion (pharma)
(total drugs market - $ 1,487 billion)
Focus was on better screening of drug
candidates and faster market launch
because the clinical development
process is risky and lengthy.
Commercialization of drug candidates is the
main focus. Non-core competencies,
including activities such as drug discovery,
drug development (early stage clinical
development), and manufacturing, are being
outsourced.
Convergence with drug discovery,
drug development, and drug
delivery
M&As and alliances with pharmaceutical
firms
Very high ROI for successful drug
candidates (those with successful market
launch and positive clinical trial data on
efficacy and safety), for example,
Pfizer's Lipitor (Atorvastatin)
M&As and alliances with biotech firms
Acquisition, and alliances with drug
discovery, drug development companies, and
academic institutions reduces the growing
R&D productivity gap for the pharmaceutical
companies. De-risking of R&D and drug
development with cost-effective model is the
main driver for the growth of pharmaceutical
firms.
M&As and alliances with
drug discovery, drug development,
and drug delivery companies
Focus is on less competitive, niche
disease segments, and; thereby,
shifting away from the blockbuster
model.
Big pharma, biopharmaceutical companies,
small and medium pharmaceutical firms,
CROs, CMOs, generics
Big pharma, small and medium
pharmaceutical companies, CMOs,
CROs, generics
Integrated companies
Source: Frost & Sullivan
43
Last Decade Current Decade Next Decade
Types of
Companies
Market
Dynamics
Main Focus
Revenue
Biotechnology—Business Outlook
Approximately $25 billion Approximately $63 billion Approximately $136 billion
Main focus was on drug discovery,
leveraged by a healthy funding
scenario.
Focus is on niche disease segments such as
cancer and autoimmune diseases.
Personalized medicine - more
efficient drug development process,
based on the research on disease
pathophysiology and genetic risk
factors
The high growth rate and increasing
number of licensing and collaboration
deals in the biotech industry attracted
investments, not only from
pharmaceutical companies but also
from investment banks and VCs due to
the high future prospects of the industry.
Moreover, increased funding and
support from the government were the
other key drivers for growth of the
biotechnology industry.
Lucrative disease segments with premium
pricing opportunities such as oncology are the
main growth driver. Success of various
,onoclonal antibodies (mAb) such as Rituxan/
MabThera (rituximab) and Avastin
(bevacizumab) is a key impetus for growth.
Potential high ROI on personalized
medicine will be the main growth
driver.
Drug discovery, biopharmaceutical companies,
biotech firms, CROs, CMOs, and biosimilar
companies
Drug discovery, drug development
companies, CROs, CMOs, and biotech
firms
Integrated companies
Source: Frost & Sullivan
44
Current Decade Next Decade
Types of
Companies
Market
Dynamics
Main Focus
Revenue
Clinical Diagnostics—Business Outlook
$24,504.2 Million $40,208.3 Million $78,234.7 Million
Immunochemistry and clinical microbiology
were the largest segments mainly because
the human genome had just been
sequenced and; therefore, molecular
techniques were under development or on
their way to the market. Immunochemistry
and culture-based techniques were the only
available technologies.
As opposed to tests that needed to be
scaled up to be performed at the central
lab, tests now need to be scaled down
to be performed at the point of care, but
at the cost of a lab test. Molecular
diagnostics are now recognised as a
very effective alternative to culture-
based and ELISA-based techniques.
Personalised medicine will be mainstream,
and technologies that will enable the
personalisation of medicine, such as
molecular diagnostics and point of care
testing, will grow. Companion diagnostics
will be a main area with significant revenue,
although it is currently not significant
enough to form a part of the IVD market.
There was need for a validated technique
that could be scaled up to the volumes of
central laboratories, which offered
actionable results at economic costs. EIA
and culture-based were best-suited at that
time and; thus’ were the most widely used
techniques.
Need for speed and need at the point-of
care are the key drivers of today.
Biomarkers-based diagnostics are driving
growth in many segments, such as
molecular diagnostics, point of care, and
tissue diagnostics.
More personalised and quicker diagnosis
at the point of need will continue to be key
drivers in 2020. The transition towards
personalised medicine will lead to the
generation of significant quantities of data per
patient, making information storage and
management more critical in the future.
Laterally integrated diagnostic companies are
composed of biomarker companies, OEM
manufacturers, and the present diagnostic
leviathans. Leaders in data storage and
management in other fields such as Google
could potentially be expected to enter the
healthcare space in a big way.
EIA reagents and equipment suppliers and
reagent suppliers for both EIA and culture
techniques such as Abbott, Bio-Rad,
Bayer, Roche, Beckman Coulter,
bioMerieux, Sigma Aldrich
Diagnostic companies with multiple areas
of focus include Roche, Siemens, J&J,
Abbott, Beckman Coulter, Bayer,
bioMerieux, Sysmex, Alere, Becton
Dickinson, Instrumentation Laboratory,
Qiagen, Radiometer, and Gen-Probe.
Last Decade
Source: Frost & Sullivan
45
Last Decade Current Decade Next Decade
Types of
Companies
Market
Dynamics
Main Focus
Revenue
Medical Devices—Business Outlook
$153.40 Billion $271.55 Billion $509.25 Billion
More emphasis on quality of treatment
and cure because treatment time was
never a constraint. Invasive procedures
were the golden standard.
Faster diagnosis and prompt therapy
along with patient safety using minimal
invasive technologies
Minimal invasive technologies becoming the
preferred choice; therefore, reducing therapy
duration and post-operative complications.
Consistently increasing number of chronic
cardiovascular diseases led to most
pertinent surgical intervention when
absolutely required.
Improved diagnostic imaging capabilities
coupled with advanced minimally invasive
technologies has led to increased
procedural volume and product uptake.
Advancement in minimally invasive
technology in the form of fully automated,
robot-assisted, minimally invasive cardiac
surgery and continuous diagnostic pre-
operative imaging
Presence of individual imaging, devices,
and pharmaceutical companies, for
example, Johnson and Johnson, GE
Healthcare, and Merck and Co.
Individual companies have started moving
towards intersection, for example, BD and
Novartis.
A definite intersection of applications and
product line between established
companies. For instance, a leading vendor
from the cardiac imaging industry
collaborating with participants from the
cardiac devices and consumables
industries.
Source: Frost & Sullivan
46
Projected
Impact on the
Healthcare
Industry
High Impact
Low Impact
Certainty
Low High
2010 – 2020
Top 10 Global Healthcare Trends
Source: Frost & Sullivan
47
Three Big Predictions
2
The healthcare and life sciences industry will consolidate further in this
decade with many big pharma companies seeking alternatives to the
blockbuster model.
3
1
As healthcare is geared towards a personalized medicine model,
companion diagnostics will alter drug development and the
commercialization process of drug candidates. Combining biomarkers and
drugs will result in enhanced therapeutic efficacy and safety.
The rise of new technologies capable of integrating medical devices into a
connected platform enhances the functionality of devices, reduces the man
power burden, and minimizes errors.
Source: Frost & Sullivan
48
Healthcare Convergence
49
Healthcare—Convergence with Other Industries
Key Industries Tracked in Addition to Company’s Core Markets, 2013
A&D = Aerospace & Defence
A&T = Automotive & Transportation
CMF = Chemicals, Materials & Food
EPS = Energy & Power Supplies
EBT = Environment & Building Technologies
HC = Healthcare
IPC = Industry & Process Control
ICT = Information & Communication Technology
M&I = Measurement & Instrumentation
Industry Cross-interest 1 Cross-interest 2 Cross-interest 3 n
A&D ICT 39% A&T 26% EPS 20% 111
A&T EPS 25% ICT 24% EBT 9% 282
CMF EPS 37% A&T 36% EBT 27% 167
EPS EBT 24% A&T 20% IPC 18% 180
EBT EPS 44% ICT 26% CMF 21% 57
HC ICT 18% CMF 15% M&I 8% 238
IPC EPS 42% A&T 26% CMF 26% 78
ICT HC 23% A&T 19% EPS 19% 371
M&I A&T 42% EPS 38% IPC 38% 26
Source: Frost & Sullivan
50
Healthcare—Convergence with Other Industries
Key Areas of Technology and Business Model Convergence
Connected
Health
Life
Sciences
Advanced
Medical
Technology
ICT CMF
Robotic
Diagnostics,
Automation -
Lab-on-Chip,
LIMS, Robotic
Surgery
M&I
Active
Pharmaceutical
Ingredients,
Excipients and
Intermediates,
Drug Delivery,
Device Coatings
mHealth, Health
Information
Exchange
Systems,
Chronic Disease
Management
Healthcare
IPC A&T
Supply Chain,
Warehousing,
Freight
Forwarding Bulk
Drugs,
Chemicals,
Biologics, and
Finished Dosage.
Cryostorage of
Devices
Valves, Heat
Exchangers,
Centrifuges,
Dryers,
Bioreactor
Source: Frost & Sullivan
51
Ranking of Mega Trends
Health, wellness, and well-being is the highest ranked Mega Trend
New Business Models: Value
for Many
Future of Mobility
Social Trends
Beyond BRIC: The Next Game
Changers
Connectivity and Convergence
Future Infrastructure
Development
Smart is the New Green
Health, Wellness, and Well-
being
Urbanization: City as a
Customer
Innovating to Zero
Bricks and Clicks
53%
51%
44%
43%
42%
40%
38%
31%
29%
27%
11%
51%
51%
37%
62%
44%
38%
37%
15%
30%
30%
10%
45%
73%
45%
45%
45%
42%
35%
18%
38%
25%
10%
47%
37%
37%
50%
18%
40%
53%
38%
37%
42%
10%
50%
34%
31%
43%
33%
60%
55%
12%
33%
26%
14%
46%
24%
41%
39%
44%
44%
59%
27%
49%
32%
12%
60%
38%
52%
43%
39%
23%
18%
81%
14%
23%
8%
48%
50%
24%
43%
43%
36%
38%
22%
33%
26%
9%
62%
74%
54%
30%
70%
40%
25%
19%
20%
19%
10%
43%
29%
14%
57%
21%
43%
29%
21%
7%
21%
7%
Overall A&D A&T CMF EPS EBT HC IPC ICT M&I
A&D = Aerospace & Defence
A&T = Automotive & Transportation
CMF = Chemicals, Materials & Food
EPS = Energy & Power Supplies
EBT = Environment & Building Technologies
HC = Healthcare
IPC = Industry & Process Control
ICT = Information & Communication Technology
M&I = Measurement & Instrumentation
Source: Frost & Sullivan

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United healthcare trends discussion by Frost & Sullivan

  • 1. Growth and Innovation in the Healthcare Industry Trends, Opportunities, and Challenges January 17, 2014
  • 2. 2 Healthcare—What Survey Participants Identified as Hot Topics Rank Market Topic % of Respondents Nominating as Hottest Topic 1 Mobility in Healthcare/mHealth 51% 2 Cloud in Healthcare: Current Issues 45% 3 Regulatory Environments 44% 4 Cancer Market Outlook 39% 5 Remote Monitoring 38% 6 Drug Delivery Market 35% 7 Patient and Consumer Engagement 32% 8 Healthcare Dashboards 31% 9 Electronic Health Records/Electronic Medical Records 31% 10 Growth Drivers Impacting the Medical Devices Segments 30% 11 Drug Discovery Research Outsourcing Market 28% 12 Homecare Market Trends - Demand, Addressable Segments, Infrastructure, and Policy 25% 13 Video Telemedicine 24% 14 Cardiovascular Therapeutics - Dyslipidemia/CHD Prevention 24% 15 Changing Profiles of Influencers and Decision-makers Impacting Medical Device Choice 22% Healthcare: Identification of Hot Topics, Global, 2013 Source: Frost & Sullivan
  • 3. 3 Healthcare Policy Issues Addressing Quality, Access, Cost Incentive payments Telehealth At-Risk Contracting • Population health management • Patient Empowerment Moving the needle gets harder
  • 5. 5 Telehealth Industry—Percent Revenue Forecast by Vertical Market Note: All figures are rounded. The base year is 2012. Source: Frost & Sullivan analysis. Key Takeaway: Remote monitoring is the oldest and largest of the three subsegments, with sizable contributions from both the professional and consumer sectors Remote Monitoring 71.1% Video Telemedicine 11.4% mHealth 17.5% Telehealth Industry: Percent Revenue Forecast by Vertical Market, North America, 2012 Note: Does not include general infrastructure or managed services Market Revenue, 2012 $2.39 Billion $280M 2012 $430M 2012 $1.74B 2012
  • 6. 6 Consumers Believe mHealth Will Improve Convenience, Quality, and Cost Source: The Economist Intelligence Unit (2012 ) and PWC: Emerging mHealth: Paths for Growth (2013) and Frost & Sullivan Surveys of consumers show an increasing interest and enthusiasm for using mobile devices to engage with healthcare providers In the next three years, patients agree that… 52% 48% 46% mHealth applications / services will make healthcare substantially more convenient for me mHealth applications / services will improve the quality of healthcare I receive mHealth applications / services will substantially reduce my overall healthcare costs Top drivers for patients to begin using or increase using mHealth - Ability to access by my healthcare providers more conveniently/effectively Ability to reduce my own healthcare costs Ability to take greater control of my health Ability to obtain information that is difficult or impossible for me to obtain from other sources Ability to access better quality healthcare 46% 43% 32% 28% 25%
  • 7. 7 Which Telehealth Markets Will Have the Highest Impact on Healthcare Industry? Home Healthcare and Disease Management Base: Telehealth Respondents (ATA 2013; N=63) Q. Please rate the following telehealth markets on their level of overall impact for healthcare industry over the next five years. Remote Physician / Specialist Services Telemental Health Video Diagnostic Teleconsultation 93% 91% 73% 66% Current Opportunity Short Term Growth Long Term Growth Transformative Potential Best Business Models Industry Sector % Rating High + Very High Impact
  • 8. 8 mHealth The Most Likely Additions To Telehealth Services Base: Telehealth User responses (ATA 2012; N=83); Note: Multiple Mention Response Q. What telehealth service are you looking to add in the next 3 years? (check all that apply) *Other Selection was a write in answer. Users’ Responses Regarding the Most Likely Additions To Their Telehealth Services, North America, 2012–2015 12% 8% 12% 10% 7% 4% 10% 10% 23% 5% 0% 5% 10% 15% 20% 25% Post-discharge Remote… Telecardiology Telemental Health Telestroke/Neurology Telenursing Teleimaging Telerehabilitation Remote Consultation (Non-specialist… mHealth Other Selection* User Response Source: Frost & Sullivan.
  • 9. 9 Next Steps for mHealth Adoption  Personal devices  Professional solutions Regulation  FDA guidance finally released  Impact to date on funding Business model success  Waiting for reimbursement?  Will ACOs be the tipping point?  Sustainable consumer models? Value  Clinical efficacy still unproven?  Long term value to individuals?
  • 10. 10 Adoption and Impact of Cloud Technology
  • 11. 11 Confluence of Change in HC Driving Shift Toward the Cloud Data creation and storage Targeted Care Prevention Cost Control HC Innovation Information sharing Information access Costs Impact of genomic data
  • 12. 12 Confluence of Change in HC Driving Shift Toward the Cloud Data creation and storage Targeted Care Prevention Cost Control HC Innovation Information sharing Information access Costs Deployment speed Scalability HCIT personnel shortages Impact of genomic data Data silos
  • 13. 13 Cloud Solutions Are Aligned With Healthcare Shifts Source: Frost & Sullivan analysis Big Data Mobility Cloud Social Media Cloud allows scale in storing big data Collaboration in research means moving partners to the data Care collaboration and transitions in care require flexible access and merged data sets Cloud is a key enabler of mobilizing data for use by consumers and enterprise users Point of Care PatientLab Genomics Care Coordination
  • 14. 14 Healthcare Transformation Will Require Shared Access Source: Frost & Sullivan analysis “Within ___ years, it will be considered malpractice to treat a patient without consideration of their individual –omics data” Not if, but when… With 5,400 petabytes of raw data from next generation sequencing to be stored by 2018, cost effectively storing and making this data accessible to clinicians and researchers will require cloud solutions
  • 15. 15 Cloud Solutions Can Help Address HCIT Challenges We are creating millions of useful data points, from a wide variety of sources… DATA  INTEGRATION  ANALYTICS  ACTION …But the data is provided in separate solutions which prevent getting a holistic view of the patient Predictive analytics has arrived…Natural language processing will become a commodity… ,,,But working with only part of the data Analytics alone cannot drive process change. Analytics ideally need to create actions, with prompts and information embedded in workflows (not in stand- alone platforms)
  • 16. 16 Trust Among Consumers 74% of patients are comfortable having their health records available in the cloud, assuming adequate security (excluding Germany and Japan) According to a recent survey of 6,000 people in 10 countries (sponsored by Cisco) Consumers view benefits as outweighing costs or risks of storing health information in the cloud – at least to the degree they understand the risks
  • 18. 18 Leveraging Big Data To Reduce Healthcare Costs NaturalLanguageProcessing Biometric sensors
  • 19. 19 Types of Analytics Applied in Healthcare Big Data Solutions What Happened? MoreTraditional HealthcareAnalytics PREDICTIVE ANALYTICS COMPARATIVE ANALYTICS PRESCRIPTIVE ANALYTICS DESCRIPTIVE ANALYTICS What Will Happen? NewAnalyticsTools NeededByACOs Source: Frost & Sullivan
  • 20. 20 Vendor Consolidation, Startups and Large IT Market Entrants Software, Platform, Integration, Customization, Consulting, Services
  • 21. 21 Opportunities to Leverage Big Data Source: Frost & Sullivan Clinical Decision Support (Accelerate dissemination of research findings) Individualization of Treatment and Interaction Comparative Effectiveness and Outcomes Research Clinical Trial Design Microsegmentation of Cohorts and Consumers Direct-to-Consumer Analytics New Data Sets, New Tools, New Business Models
  • 23. 23 Consumerization Behavioral economics Quantified self Increased individual financial responsibility Social networks and online health resources Source: Frost & Sullivan
  • 24. 24 Patients Bring A Consumer Mindset To Healthcare Interactions Consumer Expectations  24 / 7 / 365 support via phone, chat, etc.  Direct outreach to consumers based on consumer preferences  One stop resolution or call backSource: Frost & Sullivan. • Customer service focus • Comparison shopping • Self-service, online shopping • Special offers • Proactive outreach to stimulate consumer response • One stop shop • Anytime, anywhere service Entertainment, Media, & Telecommunications Transportation & Distribution Retail & Finance • Customized products • At-home service • Variety • Engaging interface  Ability to control and customize  Flexibility and convenience  Anytime, anywhere options  Real time info at point of use  Info comes to consumer  High levels of interaction and Q&A online and in person “We have not been able to accelerate to that next level of providing that customer experience that people come to expect when interfacing with a hotel or other industry”
  • 25. 25 What Are Consumers Looking For From Healthcare Engagement? • Breaking down “bricks and mortar” approach to healthcare • 24/7 access to personal health information via web portal • Ability to communicate with providers via email • Test results and other data delivered via mobile devices • Online scheduling and bill pay • E-visits  Convenience Engagement Personalization • Preference-based care vs. evidence-based care • Customized approach to communication • “Respect my wishes for privacy and security” • Clear explanations of condition • Content to help patients understand health status • Shared-decision making • “In the loop” – treat patient like a member of the healthcare team • “I want all my information in one place so my community has access” Source: Frost & Sullivan
  • 26. 26 Social Networks: Where Patients Are Empowered Patients flock to sites to share experiences and learn from others with similar conditions What do people discuss online regarding health conditions? • Symptoms • Treatment options • Medications, side effects, etc. • Doctor-patient interaction • Emotional support What health conditions are discussed? • Breast cancer • Depression • Bipolar disorder • Arthritis • Cardiovascular disease • Fibromyalgia • Alzheimer’s disease Source: NM Incite, Frost & Sullivan analysis.
  • 27. 27 Consumer Attitudes Towards Care Delivery Are Changing 76% of patients say access to care is more important than physical human contact with their care provider 70% of patients would trust an automated device to provide a diagnosis and determine whether or not they needed to see a doctor According to a recent survey of 6,000 people in 10 countries (sponsored by Cisco) 87% of patients would trade off time, money and/or convenience to be treated at a perceived leading healthcare provider, and gain access to trusted care and expertise
  • 28. 28 Two Views of the Provider–Patient Relationship Information giving Authoritarian (parent-child) Dictated behavior Compliance Resistance is bad Persuade, Manipulate Information exchange Shared decision making, Cooperation Negotiated behavior Adherence Resistance is information Understand, Adjust, Accept We save the patient Patient saves themselves Practitioner centered Patient centered Source: Steve Basiago, Walgreens Health Services
  • 29. 29 Multi-Channel Approaches Add Value In Patient Engagement IVRText EmailVoice Report Data Self Service Inbound Outbound At-Risk Motivate Quality Measures Educate Live Agent ChatVideo • More interactions • More often • Engagement more critical • Personalization in interaction • Approach depends on engagement goal • Automate, escalate, engage Patient experience changes over time: optimism, acceptance, knowledge, social support, etc. Source: Frost & Sullivan
  • 30. 30 Opportunities to Address Empowered Patients • Consumer is addicted to repairative care  Value of preventative care not sold • Health literacy is low, anxiety regarding diagnosis • Not just data, what’s the meaning • Information provided like a financial statement • Here’s where you started the month...this month’s activities...here’s where you are now Gaming, Rewards, Motivation Combine patients to create consumer power Content that is individualized + personalized Network, Collaborate Source: Frost & Sullivan analysis. Patient ownership of data Research and market products designed for specific types of patients Direct-to- consumer analytics Packaged episode of care bundle, customized and purchased online
  • 32. 32 Interoperability Platform Medical Device Connectivity Oximeter Infusion Pumps Monitors Electronic Medical Record Workstation Medication Station Smart phone or tablet Other Diagnostic Devices or Biometric Sensors Point-to point Connectivity enables Standardized Electronic Records, Remote Healthcare and Diagnostics, Remote Clinical Care, Electronic Medical Records, and Mobile Healthcare.
  • 33. 33 Key Configuration Considerations Categorizing Devices System Deployment Patient association is critical to effective implementation of connectivity solutions. Initiation can either be patient centric or location centric. Ensuring tracking across the worflow and proper patient disassociation is of equal importance. Categorization of devices based on use and data transmission. Episodic devices obtain a single set of measurements at a fixed time. Continuous tracking devices, are continuously capturing data and device performance information, some are stand alone while others can transmit across an enterprise network. Deployment is tied to how the device fits in the clinical workflow. Does it require a point of care component, or is central station monitoring sufficient. Patient Association Synchronized time stamping, security from malware, downtime protocols, and integration of data with an EMR are among the most challenging issues to adoption of interoperability systems. Data Validation and Security Protocols for change management as devices get replaced or upgraded are important to factor into the network, and consider contingencies of how changes to one might affect another. It requires coordination from both institutions and OEM’s.. Change Management
  • 34. 34 Spheres of Influence Lack Alignment Key Supporting Organizations Supporting Organizations for Interoperable HC Systems Clinicians Patients Professionals in leading HC Organizations System Safety Experts Manufacturing Representatives Standards Setting Organizations Regulatory Bodies Research & Academic Institutions Patient Safety Advocates Payers
  • 35. 35 Available Third Party Solutions – Qualcomm Life • With the acquisition of Healthy Circles and investment in PracticeFusion, Qualcomm Life is expanding capabilities for data integration and potentially analytics
  • 36. 36 Available Third Party Solutions- Netspective Fluent M2M
  • 37. 37 Available Third Party Solutions – iSirona and Capsule Technologies
  • 38. 38 ECRI Use Case Analysis - Vendor Comparison Automated Documentation from a Ventilator
  • 40. 40 Personalization, Communication, Decentralization, Collaboration Personalized/Precision Medicine Patient Centric Decentralized, Community-based Collaborative, Shared Information Based on Protocols and Analytics Preventing Sickness (Wellness) Integrated, Two Way From... One Size Fits All Provider Centric Centralized, Hospital-based Fragmented, Specialized Based on Individual Expert Treating Sickness Fragmented, One-way INFORMATION FLOW LOCATION FOCUS APPROACH TREATMENT DECISION MAKING OBJECTIVE ...To Procedure-based Bundled, CapitatedREIMBURSEMENT Source: Frost & Sullivan
  • 41. 41 Care Delivery Transformation: From Acute Care to Prevention Track, Predict, Intervene, Manage Disease/Care Management Prevention/Wellness Goal: Keep People Healthy Longer Goal: Manage or Mitigate Risk Goal: Diagnose and Reduce Treatment Delay Goal: Manage Goal: Quality of Life Goal: Move to More Interaction and Self- Mgmt Healthy/ “Worried Well” “At Risk” Undiagnosed Chronically Ill Managed Chronically Ill Unmanaged End of Life Continuum of Care SizeofImpactedPopulation $$ •Early identification and prevention •New models of care delivery to improve: •collaboration among providers •patient knowledge, self-help and health •Increase intervention •Higher touch at lower cost Source: Frost & Sullivan
  • 42. 42 Last Decade Current Decade Next Decade Types of Companies Market Dynamics Main Focus Revenue Pharmaceuticals—Business Outlook Approximately $328 billion (pharma) (total drugs market - $353 billion) Approximately $766 billion (pharma) (total drugs market - $830 billion) Approximately $1,350 billion (pharma) (total drugs market - $ 1,487 billion) Focus was on better screening of drug candidates and faster market launch because the clinical development process is risky and lengthy. Commercialization of drug candidates is the main focus. Non-core competencies, including activities such as drug discovery, drug development (early stage clinical development), and manufacturing, are being outsourced. Convergence with drug discovery, drug development, and drug delivery M&As and alliances with pharmaceutical firms Very high ROI for successful drug candidates (those with successful market launch and positive clinical trial data on efficacy and safety), for example, Pfizer's Lipitor (Atorvastatin) M&As and alliances with biotech firms Acquisition, and alliances with drug discovery, drug development companies, and academic institutions reduces the growing R&D productivity gap for the pharmaceutical companies. De-risking of R&D and drug development with cost-effective model is the main driver for the growth of pharmaceutical firms. M&As and alliances with drug discovery, drug development, and drug delivery companies Focus is on less competitive, niche disease segments, and; thereby, shifting away from the blockbuster model. Big pharma, biopharmaceutical companies, small and medium pharmaceutical firms, CROs, CMOs, generics Big pharma, small and medium pharmaceutical companies, CMOs, CROs, generics Integrated companies Source: Frost & Sullivan
  • 43. 43 Last Decade Current Decade Next Decade Types of Companies Market Dynamics Main Focus Revenue Biotechnology—Business Outlook Approximately $25 billion Approximately $63 billion Approximately $136 billion Main focus was on drug discovery, leveraged by a healthy funding scenario. Focus is on niche disease segments such as cancer and autoimmune diseases. Personalized medicine - more efficient drug development process, based on the research on disease pathophysiology and genetic risk factors The high growth rate and increasing number of licensing and collaboration deals in the biotech industry attracted investments, not only from pharmaceutical companies but also from investment banks and VCs due to the high future prospects of the industry. Moreover, increased funding and support from the government were the other key drivers for growth of the biotechnology industry. Lucrative disease segments with premium pricing opportunities such as oncology are the main growth driver. Success of various ,onoclonal antibodies (mAb) such as Rituxan/ MabThera (rituximab) and Avastin (bevacizumab) is a key impetus for growth. Potential high ROI on personalized medicine will be the main growth driver. Drug discovery, biopharmaceutical companies, biotech firms, CROs, CMOs, and biosimilar companies Drug discovery, drug development companies, CROs, CMOs, and biotech firms Integrated companies Source: Frost & Sullivan
  • 44. 44 Current Decade Next Decade Types of Companies Market Dynamics Main Focus Revenue Clinical Diagnostics—Business Outlook $24,504.2 Million $40,208.3 Million $78,234.7 Million Immunochemistry and clinical microbiology were the largest segments mainly because the human genome had just been sequenced and; therefore, molecular techniques were under development or on their way to the market. Immunochemistry and culture-based techniques were the only available technologies. As opposed to tests that needed to be scaled up to be performed at the central lab, tests now need to be scaled down to be performed at the point of care, but at the cost of a lab test. Molecular diagnostics are now recognised as a very effective alternative to culture- based and ELISA-based techniques. Personalised medicine will be mainstream, and technologies that will enable the personalisation of medicine, such as molecular diagnostics and point of care testing, will grow. Companion diagnostics will be a main area with significant revenue, although it is currently not significant enough to form a part of the IVD market. There was need for a validated technique that could be scaled up to the volumes of central laboratories, which offered actionable results at economic costs. EIA and culture-based were best-suited at that time and; thus’ were the most widely used techniques. Need for speed and need at the point-of care are the key drivers of today. Biomarkers-based diagnostics are driving growth in many segments, such as molecular diagnostics, point of care, and tissue diagnostics. More personalised and quicker diagnosis at the point of need will continue to be key drivers in 2020. The transition towards personalised medicine will lead to the generation of significant quantities of data per patient, making information storage and management more critical in the future. Laterally integrated diagnostic companies are composed of biomarker companies, OEM manufacturers, and the present diagnostic leviathans. Leaders in data storage and management in other fields such as Google could potentially be expected to enter the healthcare space in a big way. EIA reagents and equipment suppliers and reagent suppliers for both EIA and culture techniques such as Abbott, Bio-Rad, Bayer, Roche, Beckman Coulter, bioMerieux, Sigma Aldrich Diagnostic companies with multiple areas of focus include Roche, Siemens, J&J, Abbott, Beckman Coulter, Bayer, bioMerieux, Sysmex, Alere, Becton Dickinson, Instrumentation Laboratory, Qiagen, Radiometer, and Gen-Probe. Last Decade Source: Frost & Sullivan
  • 45. 45 Last Decade Current Decade Next Decade Types of Companies Market Dynamics Main Focus Revenue Medical Devices—Business Outlook $153.40 Billion $271.55 Billion $509.25 Billion More emphasis on quality of treatment and cure because treatment time was never a constraint. Invasive procedures were the golden standard. Faster diagnosis and prompt therapy along with patient safety using minimal invasive technologies Minimal invasive technologies becoming the preferred choice; therefore, reducing therapy duration and post-operative complications. Consistently increasing number of chronic cardiovascular diseases led to most pertinent surgical intervention when absolutely required. Improved diagnostic imaging capabilities coupled with advanced minimally invasive technologies has led to increased procedural volume and product uptake. Advancement in minimally invasive technology in the form of fully automated, robot-assisted, minimally invasive cardiac surgery and continuous diagnostic pre- operative imaging Presence of individual imaging, devices, and pharmaceutical companies, for example, Johnson and Johnson, GE Healthcare, and Merck and Co. Individual companies have started moving towards intersection, for example, BD and Novartis. A definite intersection of applications and product line between established companies. For instance, a leading vendor from the cardiac imaging industry collaborating with participants from the cardiac devices and consumables industries. Source: Frost & Sullivan
  • 46. 46 Projected Impact on the Healthcare Industry High Impact Low Impact Certainty Low High 2010 – 2020 Top 10 Global Healthcare Trends Source: Frost & Sullivan
  • 47. 47 Three Big Predictions 2 The healthcare and life sciences industry will consolidate further in this decade with many big pharma companies seeking alternatives to the blockbuster model. 3 1 As healthcare is geared towards a personalized medicine model, companion diagnostics will alter drug development and the commercialization process of drug candidates. Combining biomarkers and drugs will result in enhanced therapeutic efficacy and safety. The rise of new technologies capable of integrating medical devices into a connected platform enhances the functionality of devices, reduces the man power burden, and minimizes errors. Source: Frost & Sullivan
  • 49. 49 Healthcare—Convergence with Other Industries Key Industries Tracked in Addition to Company’s Core Markets, 2013 A&D = Aerospace & Defence A&T = Automotive & Transportation CMF = Chemicals, Materials & Food EPS = Energy & Power Supplies EBT = Environment & Building Technologies HC = Healthcare IPC = Industry & Process Control ICT = Information & Communication Technology M&I = Measurement & Instrumentation Industry Cross-interest 1 Cross-interest 2 Cross-interest 3 n A&D ICT 39% A&T 26% EPS 20% 111 A&T EPS 25% ICT 24% EBT 9% 282 CMF EPS 37% A&T 36% EBT 27% 167 EPS EBT 24% A&T 20% IPC 18% 180 EBT EPS 44% ICT 26% CMF 21% 57 HC ICT 18% CMF 15% M&I 8% 238 IPC EPS 42% A&T 26% CMF 26% 78 ICT HC 23% A&T 19% EPS 19% 371 M&I A&T 42% EPS 38% IPC 38% 26 Source: Frost & Sullivan
  • 50. 50 Healthcare—Convergence with Other Industries Key Areas of Technology and Business Model Convergence Connected Health Life Sciences Advanced Medical Technology ICT CMF Robotic Diagnostics, Automation - Lab-on-Chip, LIMS, Robotic Surgery M&I Active Pharmaceutical Ingredients, Excipients and Intermediates, Drug Delivery, Device Coatings mHealth, Health Information Exchange Systems, Chronic Disease Management Healthcare IPC A&T Supply Chain, Warehousing, Freight Forwarding Bulk Drugs, Chemicals, Biologics, and Finished Dosage. Cryostorage of Devices Valves, Heat Exchangers, Centrifuges, Dryers, Bioreactor Source: Frost & Sullivan
  • 51. 51 Ranking of Mega Trends Health, wellness, and well-being is the highest ranked Mega Trend New Business Models: Value for Many Future of Mobility Social Trends Beyond BRIC: The Next Game Changers Connectivity and Convergence Future Infrastructure Development Smart is the New Green Health, Wellness, and Well- being Urbanization: City as a Customer Innovating to Zero Bricks and Clicks 53% 51% 44% 43% 42% 40% 38% 31% 29% 27% 11% 51% 51% 37% 62% 44% 38% 37% 15% 30% 30% 10% 45% 73% 45% 45% 45% 42% 35% 18% 38% 25% 10% 47% 37% 37% 50% 18% 40% 53% 38% 37% 42% 10% 50% 34% 31% 43% 33% 60% 55% 12% 33% 26% 14% 46% 24% 41% 39% 44% 44% 59% 27% 49% 32% 12% 60% 38% 52% 43% 39% 23% 18% 81% 14% 23% 8% 48% 50% 24% 43% 43% 36% 38% 22% 33% 26% 9% 62% 74% 54% 30% 70% 40% 25% 19% 20% 19% 10% 43% 29% 14% 57% 21% 43% 29% 21% 7% 21% 7% Overall A&D A&T CMF EPS EBT HC IPC ICT M&I A&D = Aerospace & Defence A&T = Automotive & Transportation CMF = Chemicals, Materials & Food EPS = Energy & Power Supplies EBT = Environment & Building Technologies HC = Healthcare IPC = Industry & Process Control ICT = Information & Communication Technology M&I = Measurement & Instrumentation Source: Frost & Sullivan