1. Health Cloud:
Challenges and Business Opportunities
Jenn-Hwan Tarng & Chi-Hung Lin*
General Director, Service Systems Technology Center,
Industrial Technology Research Institute (ITRI)
*Commissioner, Department of Health, Taipei City Government
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2. Outline
 Aging Population
 Health ICT Global Market
 Example of View From Government
 Ubiquitous Health Services and
Solution
 Challenges and Policy
 Proposed Topics to be discussed
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3. Aging Population
Europe Latin America
and the carib
bean
Northern
America
oceania
Source: United Nations (2011)
The percentage of aged 65 and above
population (%)
Asia
year
Source: Public Health of Taipei City: 2010 Annual Report
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4. Healthcare: A Global Socio-Economic Challenge
 Population aging: a global demographic phenomena
—
US: 19.6% (2030); EU: 40% (2050); Japan: 36% (2050)
—
Healthcare cost per person aged 65+ years is 3-5 X greater than that
for person aged < 65 years
—
US: 17% of GDP (2008); 20% of GDP (2015)
 Excessive costs of administering the health system are one of
major factors for high healthcare costs*
– Unnecessary diagnosis/treatments, inefficient healthcare
management system, and expensive doctors’ practices
 Insufficient number of medical doctors and nurses.
 An automated health caring system is needed at hospital,
communities, home and mobile space.
* Source: Annuals of Internal Medicine 2005 & U.S. Census Bureau. An Aging World:
2001
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5. Healthcare Service Evolution
Treatment-centric
 Prevention-oriented home-based
personalized healthcare
Treatments
(Institute Care)
Sub Acute
(Intermediate Care)
Prevention
Wellness
Personalized Healthcare
 Home/ Mobile
 Community
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6. ICT Market in Healthcare
Market Scale in USA and China
US ICT market in Healthcare
USD billion
preventive
care field
Medical
field
2009
Health
management
1.35
HIS
Home care
field
15.69
Home care,
Disease
Management
0.58
CAGR
17
(2014)
8
EMR、EHR
Future
Market
estimation
2011
16%
about
40
1.43
(2016)
(Information
Week ,2011)
21.46
(2012)
1.1
(2014)
6%
15%
China ICT market in Healthcare
preventive
care field
Medical
field
Home
care field
Health
management
2009
Future Market
estimation
CAG
R
0.5
1.2
(2014)
20%
0.334
USD billion
0.856
(2016)
15%
0.26
1.1(2014)
33%
EMR、EHR
HIS
Home care,
Disease
Management
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 Three Market Demands
• Preventive care field
• Medical field
• Home care field
 2.2 million people adapted Telehomecare Monitoring service in
US and Europe (2011) .
(myocardial infarction,
Obstructive Sleep Apnea
Syndrome, diabetes, Chronic
Obstructive Pulmonary Disease)
 In 2011 healthcare ICT is about
2% of the total Healthcare output
in US (2.4 trillion USD).
(only 1% in 2009)
 US Healthcare ICT grow at a
CAGR 24% between 20112014(InformationWeek，2011)
Source of the materials : Frost & Sullivan(2008, 2009, 2010); ITRI IEK(2010)
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7. Health Cloud Market
Market Scale in Global
Health Cloud Market in Global
Billion
USD
Year
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• In 2011, cloud had only four
percent share of e-healthcare
market. Cloud market share will
grow to 20.5 percent a year
by 2017
• Cloud computing market in the
health care sector is expected to
grow to $5.4 billion by 2017,
according to research firm
Markets and Markets.
• The healthcare cloud computing
market is a fragmented in nature
and no provider occupies more
than five percent share. (2012)
Source: IBM/Bizcloud
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8. View From Government
Formation of an aged society
Low birth rate
Increased life span
Ageing/Aged
society
Child development
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Development in
the prime of life
Active aging
Source: Department of Health, Taipei City Government
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9. View From Government
Public
Health
Health
Care
Health for All
To reduce health
inequality
To increase healthy
life expectancy

To promote quality of healthy life
 To prevent disease
 To decrease co-morbidity and
premature death

Health Promotion and Disease Prevention
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To narrow health disparities due to life cycle
 To narrow health disparities due to
socioeconomic background
 To narrow health disparities due to
physical& mental status
Social Welfare and Safety Net
Source: Department of Health, Taipei City Government
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10. Ubiquitous Health Services for All
 Ubiquitous Health Services: Users can access services when needed at
anytime, from anywhere with any devices
 Mobile Phone, Pad, Health ATM,
 Wareable Health MaaS/ coaching devices: iShoes, Google Glasses, i-bracelet
band
 Service providers can provide needed healthcare resources and services
when needed
 E-Hospital, Community Healthcare ICT, Home Healthcare ICT, M-Healthcare
 Cloud Computing is an emerging enabling solution to address costeffective, personal, and on-demand service requirements of ubiquitous
health for all
Health Cloud Definition
A cloud computing solution used by health care providers for
health information management: storing, maintaining and
backing up; and information mining / feedback, etc.
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11. End-to-End Tele-healthcare Solution Architecture (ITRI)
and Cloud Service Models
Community
caregiver
Customer/Patient
physician
Value-added services
Cloud Service Models :
 MaaS
 PaaS
 CaaS
 IaaS
 SaaS
 Call Center Services
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12. Health Cloud Planning in Taiwan
Hospital service
efficiency
improvement
Personal knowledge/
habits improvement
Health Preventive Care
Cloud
Preventive
At Risk
sub-acute
diseases
care
PHR
Patient
Instructions
Medicare Cloud
chronic
diseases
Personal Health
Data Cloud
acute
diseases
PMR
EMR
Long-term
care
Home
care
Institutional
care
Care services
propagation
Community
care
Healthcare Cloud
Health data valueadded services
PCR
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Source: Ministry of Health, Taiwan (ROC) 12

13. Taipei Health Card / National Health Insurance IC Card
Triggering Health Cloud Services
preventive care
Social
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Source: Department of Health, Taipei City Government 13

14. Challenges of Health Cloud Adoption
• Medical liability
 Monitoring data accuracy, false alarm, signal integrity
• Privacy-preserve security protection of patient
record
• Information exchange among different organization
and customers
• Practical clinical use?
• System interoperability/scalability
 Standard, Specification, Certification & Validation
 User compliance and interface
• Integration of com. gateway and sensors
• Who’s going to pay
 The payment system for preventive medical care in
general is not in place yet in Taiwan
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15. Taipei Policy Design of Health Cloud
1. The issue of privacy protection
• The role played by the governmental domain
• The use of pseudo-ID (as privacy shield)
• The core value of doctor-patient relationship
2. Technology for humanity
• Cloud computing
• Wireless sensing
• Ultra wideband (UWB) sensing
• Computer/human interface technologies
3. The hub-based network approaches
• Delivery, delivery, delivery
• Focus on service availability/accessibility in the
community
• The hub’s cluster effect for industry development
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Source: Department of Health, Taipei City Government 15

16. Proposed Topics to be discussed
• The adoption of information and communication
technologies with regard to tele-care or tele-medicine.
• The development and function of the professional telecare human resource.
• The value-chain and the business model of the cloudbased application service.
• The performance criteria of the cloud-based application
platform.
• Multidisciplinary complex system: domain knowledge,
Information flow, service process, and cash flow.
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17. Thanks for your attention !
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