SEWAHSP Industry workshop, 10th January 2013, Cardiff

1. International opportunities
for healthcare services,
research & innovation
R. Bleddyn V Rees
• Non Executive Director – European Connected Health Alliance
• Partner, Head of International Healthcare – Wragge & Co LLP
10 January 2013
Presentation: South East Wales Academic Health Science Partnership

2. 1. Who am I?
 Lawyer & Head of Healthcare at Wragge & Co LLP, an
international law firm. (NB separate Pharma & Life Sciences
team).
 Seconded to Department of Health for 3.5 years as General
Counsel of the Commercial Directorate.
 Non-Executive Director of the European Connected Health
Alliance & industry advisor for English AHS Network.
 Advise the Departments of Health of 6 countries, NHS
Commissioners, NHS Foundation Trusts, private health & social
care businesses, local authorities, housing associations, charity &
voluntary sector, Pharma, life sciences & technology business.
 My home is in Cardiff.
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3. 2. What is the European Connected Health Alliance?
Europe s largest Connected
Not for Profit
Health Membership
Company Organisation
1 2
Membership includes
Departments of Health, Promotes the deployment of
Hospitals, Care Homes, GP s, Connected Health (devices &
Commissioners, services) at scale
Universities & Industry
3 on commercial terms
4
Sets up Ecosystems to deploy Provides International
Connected Health & transfer leadership
best practice & solutions for the development of
from region to region Connected Health – has
5 6 international Advisory panel
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6. 3. What is Healthcare?
WHO defines health
The Northern Ireland as a state of complete
System & Model physical, mental and
Integrated Health & social wellbeing and not
Social Care merely the absence of
disease or infirmity.
The Compton
Circle of Care
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7. 4. International Healthcare &
Comparisons : What does good look like?
% of
Per capita Healthcare % of health
government Infant Physicians Nurses
expenditure costs as a costs paid Life
Country revenue mortality per 1000 per 1000
on health percent of by expectancy
spent on rate people people
(USD) GDP government
health
US 7,290 16% 18.5 % 45.4 % 78.1 6.7 2.4 10.6
Norway 5,910 9% 17.9 % 83.6 % 80 3 3.8 16.2
Canada 3,895 10.1% 16.7 % 69.8 % 80.7 5 2.2 9
France 3,601 11% 14.2 % 79 % 81 4 3.4 7.7
Germany 3,588 10.4% 17.6 % 76.9 % 79.8 3.8 3.5 9.9
Sweden 3,323 9.1% 13.6 % 81.7 % 81 2.5 3.6 10.8
Australia 3,137 8.7% 17.7 % 67.7 % 81.4 4.2 2.8 9.7
UK 2,992 8.4% 15.8 % 81.7 % 79.1 4.8 2.5 10
Japan 2,581 8.1% 16.8 % 81.3 % 82.6 2.6 2.1 9.4
Source: OECD Health Data 2007
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8. 5. Drivers for International Opportunities
 The beginning of a global healthcare sector/industry?
 Increasing role of WHO, UN and EU in healthcare?
 The wealth of certain Middle East countries.
 Disruptive technology & business models (Clayton Christensen).
 The needs of the developing world, especially the absence of
traditional health infrastructure (hospitals and primary care
facilities) enabling disruptive technology.
 The pump priming activities of the global telecommunications
and technology industries.
 NCDs & Aging population.
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10. A shared driver for people & society
from to
reactive proactive
health management health
management
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16. 6. Middle East opportunities: Some examples
 Privatisation of existing general hospitals, e.g. United Arab Emirates initial
management contracts for:
- Johns Hopkins - Vamed
- Cleveland Clinic - Bumrungrad
 Outsourcing of the running of new hospitals, e.g. Saudi Airlines/Riydah & Royal
College of Surgeons Ireland & Bahrain.
 Partnering/JV arrangements for specialist services e.g. Guy s & St Thomas are
bidding to set up and run a cancer hospital in Qatar.
 Partnering to set up and run a new World Class Medical School for KUSTAR in
Abu Dhabi.
 Research & Development funding & programmes & endowments, e.g. Etisalat/
BT/Khalifa University Innovation Centre (EBTIC).
 International private patients (including government programmes) treated in the
UK.
 Consulting services.
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17. Other Global examples:
(1) Abu Dhabi a living laboratory…
“Big enough to ma.er, small enough to
manage…”: 2.4m popula:on, 18,000
clinicians, 1,367 facili:es
Highly strategic government with broad‐
based popular trust (use of data)
Extreme pace and depth of development,
and environment broadly, and rapid
health reform
“Sufficient complexity” to be broadly
applicable: Mul:ple payer – Mul:ple
provider
Rela:vely well‐resourced
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18. We’ve already established a range of
feedback channels
Weqaya reports
• 110,000 individual reports sent to home
addresses
• Individual Weqaya Score and risk factors
• Informa:on, basic ac:ons, brief message,
separate informa:on booklet
Weqaya Helpline (800 61116)
• Booking appointments (SMS reminders and
re‐call)
• Answering Weqaya programme queries
Weqaya website (BETA)
• Access to Personal Data
• Interac:ve, recommenda:ons based on risk
level
• Appointment booking op:on
• Links to DMPs
• Links and recommenda:ons for non‐health
sector interven:ons
• General informa:on on healthy living for
Weqaya and general public
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19. We re seeing lots of innovation in
measurement and behaviour change
technology
• Opt‐out screening
Measuring • Opt‐in data sharing
health
• Ubiquitous Weqaya
Taking health programme
promo:ng • Disease Management
ac:on Programmes
• Point of decision
prompts, e.g., Weqaya
label on healthy food
• At home monitoring
• Secure data sharing
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20. 7. Other Global Examples
(2) Moorfields Eye Hospitals & Mobile PHF records in
Africa.
(3) Etisalat – access to records and midwifes via mobile
for pregnant mothers in Africa.
(4) Nike Fuel Band – Wellbeing & retail.
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21. (4) Nike Fuel Band: Well being data &
tracking
Motivation
:Share with friends
:Compete against friends
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22. 7. Other Global Examples
(5) Growth of new services for wellbeing
 Hea!thrageous (www.healthrageous.com)
 Wellocracy (building community around connected health for
every day citizens)
 Objective data in feedback loops and the use of motivational
psychology
 I can t eat fudge because I can t fudge my data
 First e-book 8 January 2013
 www.patientslikeme.com
(6) Expert patients self managing long term conditions, keeping stable if
not well and avoiding expensive admissions/hospital treatment.
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23. (7) Our devices evolve towards the SoulMate
CPU
SPU SoulMate
Smart Phone Liferecorder
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24. (8) Heia Heia - Social Wellness
Every move counts,
whatever the activity
Socializing within a
health related service
drives up motivation
Walking the
dog is the 5th
most popular
activity in
Finland
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25. 8. What is a Connected Health Ecosystem?
Dictionary – a system involving the interactions between a community and its non-living
environment.
Commissioners of Healthcare
Commissioners of Social Care
CONSUMERS
PATIENTS
PEOPLE
Secondary Community Primary Domiciliary Assisted Care Homes
care care care
US services Living services services
Public Providers Industry University & Research Organisations
 Health and social care providers • Pharmaceutical
 Technology devices, equipment and services • ICT software (telecoms)
equipment and services
 Consumer healthcare products and services
• Research
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26. The Manchester Ecosystem
Health & Social Care Higher Educa:on Research Base
Commissioners
Open Innovation Partnership
Industry
Health & Social Care
Providers Technology Devices & Services
Public Providers
ICT & Telecoms
Private Providers
Software
Primary Community Assisted Care Secondary Pharma
Care Care Living Home Care
Integration
Patients, Families, Services
Citizens
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27. 8. The ECH Alliance Manchester Ecosystem
 Organised around the Manchester Academic Health Science Centre (MAHSC),
one of only 5 UK Department of Health approved partnerships between NHS
Hospitals and the clinical teaching and Business schools of a University.
 MAHSC comprises the 5 major Manchester hospitals (a mental health, cancer
and 3 Tertiary District General Hospitals) and the Business School and clinical
teaching schools (including medicine, nursing, optometry, pharmacy and
dentistry) of Manchester University.
 Includes Manchester Digital Development Agency, Greater Manchester Research
Network and the University of Manchester mHealth Innovation Centre.
 Includes GP practices (as providers) and GP s as Commissioners.
 Includes Housing Associations connecting health and housing and social
care.
 Includes Local Authorities as the commissioners of social care.
 Includes the ECHAlliance industry members who provide potential ideas,
solutions and services.
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28. 8. The ECH Alliance OuluHealth Ecosystem (Finland)
PaLents, Families, CiLzens
Health & Social Care Providers Business Industry focus areas
Public Providers Model Wireless Health Monitoring
eg. remote diagnos:cs
Private Providers Individualized Healthcare
eg. assisted living, mental health
Genes and Lifestyle
Centre for Health and Technology
Oulu InnovaLon Alliance (OIA):
Oulu University, Oulu Univ. of Applied Sciences, City of Oulu, VTT &
Technopolis
5 OIA InnovaLon Centres, eg. CHT
Funding : City of Oulu, Social and Health Ministry, Tekes, Sitra, EU, etc.
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29. 8. ECH Alliance Ecosystems – What are they all about?
Developing existing networks
Focusing on doing rather than just talking
Connect to the ECHAlliance
international network
Barcelona
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30. 8. ECH Alliance Ecosystems – What are they all about?
Ecosystems: a driver for integration & economic development with
HEALTHCARE AS AN INVESTMENT NOT COST.
Health &
Social Care
Services
Education
Research &Training
Engine for investment growth and economic development
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31. 9. Challenges
 US Teaching Hospitals have very professional and formidable sales
skills.
 US healthcare standards are being adopted to train tomorrow s
doctors.
 NHS is late to global opportunities and a little arrogant
 The NHS brand is not always an exemplar!
 Culture, e.g. Middle East Sheria law, beaurocratic procurement
process and obtaining payment!
 Competition between NHS organisations abroad (cf Lord Darzi).
 World class standards, comparative system reviews & management
consultants.
 Complexity of systems, laws and lack of transparency?
 Clinical & Financial Evidence v risk management.
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33. A communication gap between healthcare pros and patients
“The patient is the most
underused resource in
medicine”
e-Patient David deBronkart
Tim O’Reilly
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34. A potent service design combo
Aggregated meta data
Wearable sensing Minimal
presented in motivational
personal input
form
Wellness transformation
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36. 10. ECH Alliance: How can you help us?
 Become members! (www.echalliance.com)
 Tell us about any ideas you have to improve patient
services.
 Tell us about any solutions (devices or services) you
would like to deploy in our Ecosystems.
 Help us make our Ecosystems a success.
Questions?
bleddyn_rees@wragge.com www.wragge.com
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