Healthcare Global - December 2018

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DE C E MBE R 2 0 18

Digital disruption of the healthcare sector

Social Business

Accessible healthcare through collaboration

International TRANSFORMING HEALTH INSURANCE THROUGH TECHNOLOGY

Canada’s healthcare industry: a digital transformation Industry Lead Peter Jones on how the tech giant is revolutionising the industry

TOP 10

HEALTHCARE INNOVATIONS OF 2019

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WELCOME

W

elcome to the December issue of Healthcare Global. It is no exaggeration to say that Microsoft has changed the world, as it has transformed nearly every part of people’s working and home lives - after all, around a fifth of the world’s population uses Microsoft products on a daily basis. Next, the IT giant is set to revolutionize healthcare.

Healthcare IT has traditionally been focused on hospital-based Electronic Health Records (EHR), but part of Microsoft’s digital vision is to move beyond this and onto more efficient processes. Peter Jones, Microsoft’s Industry Lead in Healthcare for Canada, explains: “Traditionally we’ve spent a lot of money and resources on digitizing healthcare records. We are now focused more on systems of insight that will enable us to access data and make better decisions on patient care and the operations in the hospital.”

As healthcare costs continue to esca-

late, Catherine Sturman spoke with Mitesh Patel, Medical Director at Aetna International, regarding the company’s development of worldclass health management solutions for governments, corporations and providers worldwide, providing health benefits to more than 800,000 members worldwide.

We also take an extensive look at the top 10 medical innovations which will gain further traction in 2019, as well as showcasing the essential healthcare events coming up this year. And don’t forget to check out our company profiles with Novartis Social Business, Microsoft Canada and PetalMD. As always, we welcome your feedback on Twitter, @HealthcareGlbl Enjoy the issue!

Catherine Sturman.

Catherine.Sturman@bizclikmedia.com w w w. h e a l t h c a r e g l o b a l . c o m

05

CONTENTS

10

Microsoft Canada

HOW MICROSOFT IS TRANSFORMING CANADA’S HEALTHCARE

22

Petal MD

Revolutionizing the healthcare sector with digital disruption

34

60 Top 10

healthcare innovations for 2019

International

educating health consumers through

innovation

Social Business Blending profit with purpose

48 48

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11

HOW MICROSOFT IS TRANSFORMING HEALTHCARE IN CANADA Industry Lead in Healthcare for Canada, Peter Jones, explains how the IT giant’s digital vision is set to revolutionise the industry WRIT TEN BY

LEIL A HAWKINS PRODUCED BY

ANDY TURNER

12

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MICROSOFT CANADA

I

t is no exaggeration to say that Microsoft has changed the world, as it has transformed nearly every part of people’s working and home lives

– after all, around a fifth of the world’s population uses Microsoft products on a daily basis. Next, the IT giant is set to revolutionize healthcare.

The healthcare system faces some tough challenges.

Wait times are lengthy, whether in the emergency room, referral to a specialist, or making appointments to see a doctor, and processes can generally be slow-moving.

Meanwhile healthcare IT has traditionally been focused on hospital-based Electronic Health Records (EHR), but part of Microsoft’s digital vision is to move 13

beyond this and onto more efficient processes. Peter Jones, Microsoft’s Industry Lead in Healthcare for Canada, explains: “Traditionally we’ve spent a lot of money and resources on digitizing healthcare records. We are now focused more on systems of insight that will enable us to access data and make better decisions on patient care and the operations in the hospital.”

As well as shifting from systems of record to systems of insight, Jones explains they are moving towards systems of engagement, making it possible for patients to interact with healthcare providers in new ways.

Patient engagement is one of the four pillars of Microsoft’s model to transform the country’s healthcare system, alongside empowering care teams, optimizing operations and transforming the continuum for better patient care.

DECEMBER 2018

CANADA

14

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MICROSOFT CANADA

15

PATIENT ENGAGEMENT

with telemedicine specialists Novari

Now that it’s possible to book

Health, makes it possible for patients

everything from a taxi to a grocery

to schedule virtual consultations with

shop via a touchscreen, it makes

doctors. It’s as simple as clicking on

sense for patients to want healthcare

a meeting request in an email to carry

to be just as accessible.

out a virtual appointment from the

New technology that enables care

comfort of the patients’ home. “You

teams to monitor patients remotely is

can get access to a member of your

of huge benefit to people with chronic

care team including doctors and

conditions, as it cuts down on wait

nurses,” Jones explains.

times for appointments, and means those with limited mobility, such as the

EMPOWERING CARE TEAMS

elderly, don’t need assistance with

There are better ways to help clinicians

travelling to appointments.

communicate, collaborate, team

The eVisit, developed in conjunction DECEMBER 2018

and learn. The Office 365 platform

CANADA

“ W E ARE NOW FOCUSED MORE ON SYSTEMS OF INSIGHT THAT WILL ENABLE US TO ACCESS DATA AND MAKE BETTER DECISIONS ON PATIENT CARE AND THE OPERATIONS IN THE HOSPITAL” — Peter Jones, Microsoft’s Industry Lead in Healthcare for Canada

w w w. h e a l t h c a r e g l o b a l . c o m

16

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PetalMD has created a unique Web platform that reduces operating costs and improves patient satisfaction. Designed for hospital managers and physicians, it allows you to: Hospital Dashboard

Analytics Dashboard

Consolidate schedules and on-call lists, updated in real-time.

Visualize and monitor hospital performance.

Physician Schedule Management

Artificial Intelligence

Automate physician schedule management and simplify shift exchanges.

Optimize time and resource allocation through the use of powerful algorithms.

Patient Booking

Secure Messaging

Synchronize appointment booking channels and facilitate patient access to healthcare.

Ensure communication and document exchange confidentiality.

Used by 37,000 physicians

•

Deployed in 5 countries

For more information, visit www.petalmd.com or call a specialized advisor at 1-888-949-8601.

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Adopted by 150 hospitals

CANADA

allows members of the care team

OPTIMIZING OPERATIONS

to communicate and collaborate on

Health is data rich and information

better patient care.

poor. Jones goes on to say that the

“If you look at how we’re moving

data collected in clinical systems is

beyond EHR, one of the biggest

generally for operational, comm-

challenges has been communication

unication or medical purposes, most

amongst care teams” Jones says.

systems do not store communications

“Many care team members are over-

in a way that makes analytics easy,

worked and struggling to produce

and an enterprise-wide system view

but putting the communication and

doesn’t emerge organically. “For an

collaboration tools in place has allowed

industry that prides itself on being

them to become more efficient and

evidence-based, health does a poor

more effective in their job.” A good

job at using the most recent and rel-

example of this is a solution from

evant evidence, their own data.

a partner called PetalMD. It offers a cloud-based solution

“We see analytics as a continuum spanning retrospective reporting,

to help physicians create, manage

real-time dashboarding, predictive

and collaborate on scheduling

analytics, and even prescriptive

shifts with co-workers. It helps

decision-making using cognitive

saves time, allows remote access

services and machine learning. Even

to schedules, provide tasks and

relatively basic initiatives like patient

transfers all in one platform on Azure,

journey-boards and KPI dashboards

dramatically reducing errors and

can have a huge impact on baselining

prevent outdated information or

performance, identifying bottlenecks

duplicates. All information, such as

and streamlining operations.

schedule events or even a physi-

“We see that effective use of data

cian’s phone number, are instantane-

analytics as the only proper way of

ously updated. Members can easily

achieving population health, whether

communicate through a secure

it’s management of chronic disease to

messaging channel.

prevent unnecessary re-admissions, w w w. h e a l t h c a r e g l o b a l . c o m

18

MICROSOFT CANADA

or supporting patients to manage their care plan, timely and accurate information is key.

“We’re seeing a lot of our partners build cloud-based solutions that are addressing these challenges and are easily adopted” he adds. One of these partners is Oculys, who have been able to show significant savings for hospitals by using data analytics to predict emergency room wait times and monitor patient flow and bad management. “If you can track it you can manage 19

it more effectively” Jones says.

TRANSFORMING THE CONTINUUM Some of the most exciting models of

is another motivator that is becoming

care leverage cloud computing. This is

increasingly apparent – some capabili-

currently the primary focus for Microsoft.

ties are only possible in the cloud.

Once viewed with scepticism by the

“The cloud is essentially a global super-

health industry due to perceived security

computer, that you can access on

or control limitations, the cloud is now

demand and pay only for what you use.

undeniably being embraced by health

You get all the benefits, yet the cost

organizations around the world. Gartner

is spread across all the users. Kind of

predicts that within this decade organi-

like timeshare.”

zations will be going to the cloud

The virtually unlimited storage pool

precisely because it is more secure

makes medical imaging storage cost

than the on premises counterpart. Part

effective, or any other big data scenario

of this momentum is driven by cost

for that matter. The incredible process-

efficiencies and outsourcing, but there

ing power makes genomic sequencing

DECEMBER 2018

CANADA

feasible. Machine learning and artificial intelligence are most practical in the cloud. Aggregations of software as a service provider, like an enterprise app store, allow organizations to discover, trial and deploy new applications with a minimum of risk and hassle. There is potential of the cloud to defragment all the data silos that frustrate holistic health information management.

Making cloud computing trustworthy is a key priority. Part of that involves making sure it is secure, and Microsoft invests over a billion dollars annually to that end. Just as important though is making sure that the cloud can be used

“ STORAGE COSTS FOR CLOUD COMPUTING ARE THE LOWEST WE CAN SEE” — Peter Jones, Microsoft’s Industry Lead in Healthcare for Canada

compliantly, so Microsoft has invested in many industry certifications like HIPAA through a Business Associates Agreement, HITECH, and FedRAMP. Keeping information private, being transparent about datacentre operations, and allowing users the controls to manage their own data round out the trust story.

LOOKING AHEAD The seemingly limitless capacity of the cloud is advantageous for initiatives such as genomic sequencing, a field w w w. h e a l t h c a r e g l o b a l . c o m

20

MICROSOFT CANADA

“ T HE CLOUD IS ESSENTIALLY A GLOBAL SUPERCOMPUTER THAT YOU CAN ACCESS ON DEMAND AND PAY ONLY FOR WHAT YOU USE” — Peter Jones, Microsoft’s Industry Lead in Healthcare for Canada 21

that is greatly expanding, and one that

are the lowest we can see, and the

includes researchers investigating

number of genomes we will need to

causes and early detection of serious

sequence in the future is going to put

conditions such as cancer. It is an area

a huge demand on a lot of the infra-

Microsoft is doing a significant amount

structure that exists on premise today”

of work in, and one that requires

Jones explains. “The other benefit is

a tremendous amount of storage given

allowing researchers to share their

that a single human genome takes up

data. The larger the genomic data set

at least 100 gigabytes of space.

the better the research, so we’re

“Storage costs for cloud computing DECEMBER 2018

starting to see researchers coming

CANADA

22

together with genomic data sharing

with providers generally waiting for

platforms that allow them to get

others to adopt new processes before

access to larger data sets.�

making the move themselves. However,

One of the organizations that has

with these innovations in telemedicine,

moved its genomic data to the cloud is

cloud solutions and operational data,

BC Cancer, a government-run agency

more and more are joining the digital

that conducts research and operates

revolution to reap its benefits.

patient treatment centers.

The healthcare industry has historically been risk averse, as Jones says, w w w. h e a l t h c a r e g l o b a l . c o m

Revolutionizing the healthcare sector with digital disruption

22

WRIT TEN BY

L AUR A MULL AN PRODUCED BY

ANDY TURNER

DECEMBER 2018

CANADA

23

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P E TA L M D

In the healthcare sector, every minute is invaluable.

Offering innovative web solutions for healthcare professionals, PetalMD is helping physicians save valuable time so they can save lives

I

ncredible advancements have continued to disrupt the healthcare sector but, behind the scenes, a lot of administrative work is still done

with the faithful pen and paper. In a sector where time is 24

of the essence, this has created a mammoth hurdle but it is one which Patrice Gilbert hoped to overcome when he founded PetalMD. The idea came to him when he talked to doctors and nurses about their daily grind in the healthcare sector.

“I was shocked by their use of technology,” he recalls.

“I realized that there was a real lack of technology penetration. In the beginning, I really saw how that, when it came to administrative tasks like scheduling, people were making decisions not based on data but subjective matters and I knew something had to change.”

One of the largest drains on time that Gilbert identified was the creation of on-call schedules. Puzzling over Excel sheets and trying to juggle conflicting time constraints of physicians means that creating schedules can cost valuable hours of time — time that could be spent saving lives. By digitizing the entire process, the DECEMBER 2018

CANADA

25

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P E TA L M D

PetalMD cloud platform aims to solve

Combined with its Petal On-Call

this. Comprised of Petal Booking, Petal

module, Gilbert says that physicians

Scheduling and Petal On-Call, this in-

also have access to a hospital dash-

novative platform hopes to facilitate

board, a clever tool that gives staff

patient appointment booking, optimize

easy access to the hospital’s on-call

physician schedule management

list in real-time, on any device. “This

and secure information exchange.

makes sure that all the staff at the

“The first module is physician sched-

26

hospital know who is on–call as well

uling: it allows a group of physicians to

as the physician’s schedule for the

better manage their group schedules,”

clinic. It saves faxes and emails back

explains Gilbert. “The platform allows

and forth and it can improve hospital

physicians to create, manage and share

productivity by making sure that

their schedules more easily in real–time.

everybody who needs to access this

It seems obvious that a group of physi-

information can do so in real–time,”

cians would have this technology today,

he notes.

but most of the time, when we deploy PetalMD we replace pen and paper.”

With its third and final module, Petal Booking, the platform also offers rich

E X E C U T I V E P R OF IL E

Patrice Gilbert Founder and CEO at PetalMD, Patrice Gilbert began his career as a product engineer at Thales Canada and Domosys. His natural leadership and vision led him to a position as Team Leader in Product Development at Taleo, where he moved up the ranks to become Product Manager for Eastern Europe in Germany. In 2009, he returned to Quebec and founded PetalMD, which earned him the title of Young Business Person of the Year for Technology and Research in 2010. Today, his passion for product development drives him towards finding new and innovative technological solutions for healthcare professionals.

DECEMBER 2018

CANADA

“ Comprised of Petal Booking, Petal Scheduling and Petal On–Call, this innovative platform hopes to facilitate patient appointment booking, optimize physician schedule management and secure information exchange” — Patrice Gilbert, Co-founder and CEO of PetalMD

insights into when the hospital is likely to be busiest or less in–demand. “There is no way a hospital can align their medical offering and their investment in equipment if they are not aware of their patient demands,” Gilbert explains. Using the Petal Booking platform, hospitals can automate tasks that are currently done manually like booking appointments or providing further information and reminders. This is then taken one step further thanks to artificial intelligence and data. “We help hospitals and their staff to better understand patient demands and, by using artificial intelligence, we can then forecast future patient demands, such as periods that w w w.he a l t hc a re gl o b a l. com

27

P E TA L M D

28

‘The physician tool provider has close ties with Microsoft — its cloud-based platform is deployed on Microsoft Azure — and this has given PetalMD the global expertise and knowledge needed to become a global operation’ DECEMBER 2018

CANADA

are likely to be busier,” he adds. “It enables physicians to plan their next schedule ahead of time. It’s the holy grail for hospitals because they are able to make decisions based not on thoughts, or subjective matters, but on real data.”

The result? More time saved, a better work-life balance, and ultimately better patient care. For physicians, it’s been an invaluable tool. “Many of the hospitals we work with, they initially reach out, because that want to improve the personal life and working life balance for their physicians,” observes Gilbert.

“They need to ensure that shifts are

29

distributed evenly within team members so, for example, when you’re working in the emergency department, they can ensure that you’re not doing too many nights in a row because this isn’t good for your health. By having all this data, hospitals can make sure to better serve their physicians. It also improves their quality of life as it’s easier to swap shifts with a few clicks of a button.”

For patients, the difference has also been palpable. “From feedback we’ve received, we see that both patients and physicians feel empowered,” Gilbert says proudly. “Patients feel like the clinic or the hospital is listening to w w w.he a l t hc a re gl o b a l. com

P E TA L M D

30

them. They can say that they’d prefer

professionals for clinicians, but that

to have an appointment on a Tuesday

is changing. Today, collaboration with

afternoon and you can more efficiently

clinicians is critical. Sensing this sea

meet that demand. Additionally, patients

change, PetalMD has done just that.

also have greater access to informa-

Indeed, in Gilbert’s eyes, what helps

tion so they understand their health-

PetalMD cut through the noise is the

care journey and they feel empowered.”

fact that it has been developed in col-

Technology has the ability to truly

laboration with physicians, with their

revolutionize the healthcare sector but

demands being placed front and center.

as more and more tools enter the fray

“In the beginning, we worked with the

it can be difficult to determine what

physicians, not just the hospitals, who

is truly useful and what could just be

would buy our software,” Gilbert re-

technology for technology’s sake.

members. “We made sure that the solu-

In the past, healthcare technology

tion would be truly helpful to physicians

was built solely by technologists or IT

and that it would meet their needs. That

2009

Year founded

51-200 Approximate number of employees

DECEMBER 2018

CANADA

CLICK TO WATCH : PETAL SCHEDULING – SCHEDULE MANAGEMENT FOR PHYSICIANS 31 way, they’d want to use it.” By proving

feat but by leveraging global exper-

its value to doctors, PetalMD has been

tise, PetalMD has done so seamlessly.

able to leave a lasting impression on

The physician tool provider has close

the Canadian healthcare sector — and

ties with Microsoft — its cloud-based

it’s proven to be a simple recipe for suc-

platform is deployed on Microsoft

cess. Today, the technology has over

Azure — and this has given PetalMD

48,000 users including 32,000 physi-

the global expertise and knowledge

cians across the country, yet PetalMD’s

needed to become a global operation.

growth isn’t just restricted to the Cana-

“Because our infrastructure and

dian market. It is also making inroads

our data are deployed within Micro-

on the other side of the Atlantic; in just

soft Azure, we can ensure that each

over a year, no less than eight hospitals

time we have a discussion with a

in Switzerland, Belgium and France

new country, we’re compliant with

have adopted the PetalMD platform.

this country’s legislation,” explains

Expanding globally can be a difficult

Gilbert. “This is for us a major partnerw w w.he a l t hc a re gl o b a l. com

P E TA L M D

ship advantage because Microsoft has a worldwide footprint. This allows us to deploy our technology within any country in the world without modification. Additionally, their commercial relationships with our customers are amazing. They already know all the hospitals around the world because, of course, most hospitals are already using Microsoft products as we speak.

So, we have relationships with potential customers around the world as well.”

As users’ online experiences become more and more seamless, customers 32

are expecting more from their IT platforms. Looking forward, Gilbert says

“ It seems obvious that a group of physicians would have this technology today, but most of the time, when we deploy PetalMD we replace pen and paper” — Patrice Gilbert, Co-founder and CEO of PetalMD

DECEMBER 2018

the Canadian firm will continue to invest in technology to ensure it can keep pace with the IT landscape at large.

“Thanks to the experience people have with Facebook, LinkedIn, or similar tools, we believe that we can’t lower the bar,” he reflects. “Our IT platform has to be mobile, it has to be accessible on a computer. It has to reflect the highest norm in security, making sure

CANADA

33

that we can work with hospitals and

countries and, because of all the suc-

patient data. So, we’re always invest-

cess we had in Canada, we’re start-

ing in new technology, and this is very

ing to explore these opportunities.

important for our employees.” On top

In the future, I want to take PetalMD

of this, the company is also eyeing up

across the word. We want to take all

further opportunities abroad, building

the lessons we have learnt and apply

on the world-class reputation it has

them elsewhere to help other coun-

developed in the Canadian market.

tries provide better healthcare.”

“Today, we receive many demands from healthcare professionals in other w w w.he a l t hc a re gl o b a l. com

LEADERSHIP

34

Social Business Blending profit with purpose Novartis Social Business’ partnership with The Global Antibiotic Research & Development Partnership (GARDP) will enable the business to increase the accessibility of generic antibiotics worldwide WRITTEN BY

DECEMBER 2018

CATHERINE S TURM AN

35

w w w.he a l t hc a re gl o b a l. com

LEADERSHIP

B

acterial infections remain a leading cause of death in children five years and under.

Following a call from the World Health Or-

ganization (WHO) to develop affordable and improved

formulations for young children which are also heat-stable, Novartis’ generic division, Sandoz, has led the way in developing essential treatments on a global scale.

With a mission to cure, discover, develop and successfully market innovative products to prevent and cure diseases, its division, Novartis Social Business (NSB) has combined its social and business aspirations to drive both profit and purpose.

36

“This sounds like how businesses should be run but in fact aren’t,” explains Dr Harald Nusser, Head of NSB. “That’s what makes NSB special. Usually, investments are evaluated on a discounted cash flow financial analysis, but we will put equal weight also on a monetisation of societal returns. We want to monetise our societal impact, so that we can make investment decisions based with equal weight, both on social return and financial return.”

One of the largest generic antibiotics’ manufacturers worldwide, its Sandoz division works to ensure supply availability, but strives to utilise adaptive research and development (R&D) tools to make sure that adults, children and the most vulnerable are able to access proper medicines.

This, Dr Nusser states, is vital to support those in tropical conditions.

DECEMBER 2018

“We want to monetise our societal impact, so that we can make investment decisions based with equal weight, both on social return and financial return” — Harald Nusser, Head of Novartis Social Business 37

“It’s not only about substance, but whether it will remain stable. Oftentimes children are almost a different species in relation to drug development. It requires us to have a more thoughtful evaluation of what they really need and require, particularly in countries where we are responsible”.

Through a recent, non-financial collaboration with the Global Antibiotic Research & Development Partnership (GARDP), NSB has worked to develop a dispersible tablet formulation of what is the most impaw w w.he alt h c are glo bal. co m

LEADERSHIP

38

ctful antibiotics currently in the pipeline.

challenges, NSB’s adaptive R&D app-

Beyond this, the company is brainstorm-

roach within Sandoz has allowed

ing with GARDP and is looking at ways

the business to anticipate demand

to increase paediatric development for

and gain a further understanding of

deadly diseases such as sepsis. Most

where to add supplies and develop

importantly, the partnership focuses

further applications.

on sharing knowledge, information and

“We have a certain strength in Sandoz

gaining insights on improving generic

to develop new formulations. For exa-

antibiotic formulations for children.

mple, we underwent a specific devel-

Although paediatric clinical trials remain limited, presenting significant DECEMBER 2018

opment of Amoxicillin as a dispersible tablet with interest from UNICEF.

39

Based on this positive experience we

becoming a significant public health

decided to do this for other medicines

issue, leading Novartis to develop its

as well,� says Dr Nusser.

stewardship programmes which work

Not only facing challenges within paediatric drug development, the pharmaceutical industry is tackling the rise

to educate the public on how to use antibiotics responsibly. “We also work with big institutions

of antimicrobial resistance as a result

and governments on the ground to

of the increased use of over the counter

make sure that we truly live our resp-

(OTC) drugs to treat common ailments,

onsibility beyond just the commercial

such as coughs and colds worldwide.

access of commodities and medicine,�

Resistance to common antibiotics is

says Dr Nusser. w w w.he a l t hc a re gl o b a l. com

LEADERSHIP

40

“ We work with large institutions and governments to make sure that we truly live our responsibility beyond just the commercial access of commodities and medicine” — Harald Nusser, Head of Novartis Social Business

Following the success of its community-led malaria initiative in India over a decade ago, which has since spread to Vietnam and Kenya, Novartis has launched its more recent programme, Novartis Access, to address noncommunicable diseases (NCDs) for those in low and low-middle income countries. The initiative has also been developed to also look at the company’s NGO supply capabilities, as it continues to sell essential medicines to international institutions, such as WHO, The United Nations Children’s Fund and more.

“Our role in going beyond what is usually expected from a pharma company is saying we need to at least spot opportunities where and how the private sector can engage - what should need to be done and how this could be done going forward,” states Dr Nusser.

Through its aim to improve access to medicine on a global scale, the company has identified three main areas of non-commercial engagement through the initiative. Whilst monetary evaluation, supply chain strengthening and the integrity of distribution chains all

DECEMBER 2018

CLICK TO WATCH : ‘OUR ACCESS PRINCIPLES’ 41 remain vital, another area has been

inuous basis has been a key focal point

developing its awareness and diagnosis

under the initiative.

capabilities in order to support health

“What we started almost three years

practitioners worldwide through

ago in Kenya where we have the first

essential training. This will enable

Novartis Access product, is the esta-

communities to interpret signs and

blishment of Management Scientists

symptoms in order to seek medical

for our supply chains. This focuses

support when required.

not only on the first level customer, but

Strengthening its supply chain, particularly for interventions around NCDs which require chronic and steady treatment and availability at local

second level customers as well. For example, faith-based hospitals are also public pharmacies.

“There was no proper implementa-

dispensaries has remained vital,

tion of first in, first out products, so they

where proper forecasting and

had to risk their products running out

availability of treatments on a cont-

of shelf-life. Management Science for w w w.he a l t hc a re gl o b a l. com

LEADERSHIP

“ We need to join forces, beyond industry and sectors, public and private, to really have an impact” — Harald Nusser, Head of Novartis Social Business 42

Health has developed a close relation-

we have shipped more than 900mn

ship with the government in Kenya,

life-saving or potentially life-saving

where our results have been conduct-

treatments of our antimalarials, the

ed together with the government.

proof individually measured was not

Based on this, we can improve health

there because we never engaged so

and develop jointly.

far into proper and independent

“I was also confronted with the fact that legally we could also not claim our

monitoring and evaluation,” he says.

“We have changed this with through

malaria programme to be a success.

the use of Novartis Access. Together

Despite the fact that we now know that

with Boston University, we have also

DECEMBER 2018

43

established a methodology on how

pany’s products can also be donated

to go about monitoring this, which has

or sold at lower prices.

led to an industry wide commitment

“Oftentimes companies have only

via Access accelerators, that at a certain

focused on measuring input and output

taxonomy for different access to medi-

parameters. For example, input could

cine interventions shall be used, which

be writing a grant of US$2mn with an

Boston University has also developed.�

NGO and then output would be how

Housing a number of different inter-

many trainings have been conducted,

ventions, such as engaging in aware-

yet we and the public would not know

ness-building in communities, the com-

the impact and the outcome of those w w w.he a l t hc a re gl o b a l. com

LEADERSHIP

training sessions. Have people really learned something? With that broader taxonomy framework, we have significantly contributed to what Boston University has developed and set a standard for the industry.

Right from the beginning, we said that everything we do needs to be public, but the question is with the methodology.”

Through engaging in a number of strategic partnerships, Novartis is acutely aware that as business and consumer needs evolve, so will its relationships. Signing a Memorandum of Understanding (MOU) for one year with GARDP, NSB will continue 44

to have regular meetings, hold internal working groups, enabling both the company and its Sandoz arm to share knowledge and expertise whilst looking at further areas of collaboration to ensure a successful, long-term strategic partnership. It will therefore be imperative for the business to remain willing to learn, while sharing dilemmas and overcoming obstacles which may arise.

Dr Nusser reflects that whilst in the past, the interest of the pharmaceutical industry was not so much on curing people but more on selling treatments – such a paradigm is changing. Novartis’ CART-T 19 cancer programme and subsequent stem cell approach is a further example of this, DECEMBER 2018

where the use of data and collaboration will largely increase and reshape the industry.

“There’s also another important role to play, and that is to focus on the prevention of diseases and not just treatment or cure,” he says.

“It’s particularly vital for NCDs; real lifestyle changes and healthy diets are all essential.

The pharma industry with all this knowledge has a role to play and a certain responsibility to be active here as well.

“In Asia and the Middle East, the rise of diabetes, for example, is everywhere. In Pakistan, if the incidents rate don’t change, then 30 years from now every second person will have diabetes. We need to join forces, beyond industry and sectors, public and private, to really have an impact.”

Novartis Social Business’ long-term vision to discover, market and most importantly, cure diseases will continue to drive its aim in blending profit with purpose. Making a social impact in Rwanda, Uganda, Cambodia, Nepal and more, the company will work to enter into a lower income strata to further gain increased visibility of an entire spectrum of different commercial needs, pricing and purposes to develop key treatments worldwide cementing its position as one of the most advanced pharmaceutical companies today.

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45

Covering every angle in the digital age The Business Chief platforms offer insight on the trends influencing C and V-level executives, telling the stories that matter CLICK TO SUBSCRIBE FOR FREE

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TECHNOLOGY

International

48

educating health consumers through innovation With over 160 years of experience in healthcare, Aetna International has been recognised as ‘Best International Private Health Insurance Provider’ and ‘Health Insurer of the Year’. Medical Director Mitesh Patel outlines the challenges and opportunities that lie ahead for the company.

WRITTEN BY

CATHERINE S TURM AN

DECEMBER 2018

49

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TECHNOLOGY

T

he health insurance industry is undergoing a rapid transformation. Escalating healthcare costs amidst a diverse global demographic has

presented a multitude of challenges for insurers in meeting member needs on a global scale. Moving

towards a consumer-centric healthcare model, patients are demanding increased control and cost transparency, as well as services which are further connected and accessible through the implementation of new technologies.

One of the industry’s largest and most prominent international health benefits providers, Aetna International has developed world-class health management solutions for governments, corporations and provid50

ers worldwide, providing health benefits to more than 800,000 members. Part of Fortune 100 company, Aetna, the business has stepped up its game in the development of products, services and programmes to cater to its international market.

Running the company’s evacuation service, Medical Director, Mitesh Patel remains passionate about providing exceptional member support, which includes keeping abreast of all new health trends and technologies. Still practising in emergency medicine, he explains that its evacuation services remain a unique selling point for the business.

“Our evacuation business is completely in-house and decisions are made in real time. I also oversee the care management programme, ensuring that members get the right treatment, at the right place and at the right time,” he says.

DECEMBER 2018

51

“We provide general health and wellbeing advice so that people who are at risk of potentially getting diabetes or are developing conditions can take action to modify their lifestyles” — Mitesh Patel, Medical Director

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TECHNOLOGY

52 “Through the care management programme, we have a particular focus on people with chronic diseases, such as diabetes and high blood pressure, but also the more serious end of the spectrum, such as those with cancer or chronic high-cost conditions. Our programme ensures there is a dedicated nurse where members are then able to establish an ongoing relationship. They are able to navigate members through a complex healthcare pathway, but also act as a point of support through the process.�

Many members, particularly in developing countries are still unable to gain DECEMBER 2018

CLICK TO WATCH : ‘TEACHING HEALTHY HABITS WITH COMMUNITY GARDENS | AETNA’ 53 essential information surrounding

once that conversation is had. After

long-term conditions, such as cancer,

a couple of days to reflect, we will then

or if they are in the final stages of life.

call back to see how they’re feeling and

Patel explains that having a dedicated

if they’ve got any questions,” he explains.

person that patients can speak to in-

“Often, customers don’t want to hear

house at Aetna International is therefore

this kind of news from an insurance

essential in enabling the ability for

company because that should be the

difficult conversations to be had in

doctor’s role. However, we’ve often

place of a medical professional who

found that once members have got

may remain reluctant to discuss.

over the initial shock, they are very

“It starts with the basics: trying to find

appreciative. Once they know what’s

out what they’ve heard about their con-

happening, they can then plan the rest

dition and what the doctors have told

of their lives.”

them and sourcing ways in which to help. Giving people time is important

Through its pre-authorisation process, the insurer also works to help identify w w w.he a l t hc a re gl o b a l. com

TECHNOLOGY

medical conditions, cases and treatments with members in collaboration with medical professionals to source the right solution. The aim of Aetna International is to undertake what is best for its members, making sure they’re not being over-treated or having unnecessary surgeries in ensure a higher quality result and increased member satisfaction.

DISEASE MANAGEMENT However, the number of people 54

affected by lifestyle diseases, such as atherosclerosis, obesity and diabetes are also placing significant pressures

“Both members and providers need to be educated that taking antibiotics is not the best solution all round.

Antibiotics have got their place, but they are for diagnosed bacterial infections only” — Mitesh Patel, Medical Director DECEMBER 2018

within health insurance and rising member costs. Tackling this head on, Aetna’s Care Management Programme has sought to identify these members and appointing nurses to outreach, provide advice on disease management, how to be compliant with medication, as well as assess member diet and lifestyle choices. The number of people with diabetes, for example, has increased from 108mn in 1980 to over 420mn in 2014 – a figure which is significantly rising. The World Health Organization

55

(WHO) has even projected that

children to lead a healthier lifestyle,

diabetes will be the seventh leading

where children will inform their parents,

cause of death by 2030.

will become full circle.

“We provide general health and well-

“Take for example, alcohol consump-

being advice so that people who are at

tion in the United Kingdom. It has been

risk of potentially getting diabetes or

stated that quarter of 18-25-year-olds

are developing conditions can take

are now teetotal. Obviously that’s not

action to modify their lifestyles,” says

just due to education, but also financial

Patel. “I think the biggest value for

pressures, et cetera, but that message

money long-term is taking this right

is getting through and is enabling

down to school level. This would have

a healthier society for the future.”

to be done by governments, where we could definitely advise. Teaching

Whilst education remains central in addressing the rise of lifestyle w w w.he a l t hc a re gl o b a l. com

TECHNOLOGY

diseases, it has also been proven to be vital in halting the rise of antimicrobial resistance worldwide.

Although this can occur naturally over a period of time, the misuse and overuse of antimicrobials is accelerating this process, threatening not only the industry’s ability to treat common infectious diseases, but also leads to higher patient costs and increased mortality rates, according to the WHO. “In the US, in the domestic part of the business, we’ve had success on tackling this, where we’ve identified people who over-pre56

scribe and written letters saying ‘Your prescription rate for antibiotics is above the trend of what your peers are doing.’ We’ve had a similar approach in the UK. That in itself has had a notable success,” notes Patel.

“Both members and providers need to be educated that taking antibiotics is not the best solution all-’round and often can do more harm than good. Antibiotics have got their place and they’re extremely useful, but they are for diagnosed bacterial infections only.”

MAKING WAVES The need in tackling lifestyle diseases is also being explored by non-traditional healthcare players. Companies such as DECEMBER 2018

Fitbit, Apple and Amazon are all continuing to develop consumer health wearables and fitness trackers, enabling users to harness greater interest and control over their healthcare. Following from the launch of Bluetooth in the early 2000s, the number of connected wearable devices worldwide is predicted to jump from an estimate of 325mn in 2016 to over 830mn in 2020.

“This is a Penicillin Moment, basically,” observes Patel. “Technologies in healthcare have got the potential to save more lives than some of the biggest inventions of the last century. There are mainly two fronts: machine learning and artificial intelligence (AI) capabilities. As this gets better and better and better, it’s going to augment the physician role. Rather than the physician spending a lot of time on diagnostics, machines can interpret scans, CT and MRI images. This trend is going to evolve.

“Secondly, the ability of the machine to collect and interpret large amounts of data and find correlations and causations that we might not even be aware of. That will give us a different perspective on diseases.

Once we find out exactly what’s going on, that’s when you have positive interventions being made w w w.he a l t hc a re gl o b a l. com

57

TECHNOLOGY

58

for that specific individual. It’s tailormade medicine.”

Such technology is already having an impact on conditions such as heart failure. Through advanced data analytics, providers can predict hospital admissions and illnesses before they occur and intervene and increase the dosage of a drug to prevent a hospital admission where required, therefore developing a personalised model of care.

“This is going to be the biggest movement of the century. The ability DECEMBER 2018

“ Technology has the potential to save more lives than some of the biggest inventions of the last century. There are mainly two fronts: machine learning and artificial intelligence” — Mitesh Patel, Medical Director

for the algorithm to analyse huge sets of data which we as humans simply can’t do and to create a personalised plan for every individual,” says Patel.

This revolution is already underway with many partnerships established in 2018. From Amazon, JP Morgan and Berkshire Hathaway joining forces, to vertical integrations of providers and insurance companies such as Cigna, Express Scripts and CVS Health’s US$69bn acquisition of Aetna, the industry is set to undergo tremendous growth.

“The main aim of all of this is going to be to build a healthier world and to benefit our members by offering a local solution. We need to have a personal relationship with our members at their time of need. By doing that, we’re touching upon the vulnerable, yet we’re delivering a phenomenal service,” adds Patel “It’s not just being a pure health insurance company, but to be seen to be bringing effective care directly to the member and making them engage with us, to lead a healthier life and actually change behaviours. It’s a combination of doing what we’re really good at doing, but also a focus on improving the member experience.”

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T O P 10

60

DECEMBER 2018

Top 10

healthcare innovations for 2019 This month, Healthcare Global takes a look at some of the top healthcare innovations set to transform the sector over the coming year WRITTEN BY

CATHERINE STURMAN

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T O P 10

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Telehealth The telehealth market is booming. Consumers are leading increasingly busy lifestyles, with up to 60% favouring digitally-led services.

Providing clinical care at a distance, increasing accessibility and eradicating potential delays has given patients greater control, boosting patient satisfaction and overall engagement. Such is its exponential growth, The Centers for Medicare and Medicaid Services in the US has recently released its proposed Physician Fee Schedule and Qualified Payment Programme updates for 2019, where telehealth services has been heavily featured, in order to deliver ‘different access points’ for patients.

DECEMBER 2018

63

Mobile technology Consumers have become accustomed to accessing their data through the use of various digital tools, where the use of mobile and tablet health apps has tripled from 13% in 2014 to 48% today. Catering to this growing market, British based start-up Babylon Health is making waves on a global scale. Partnering with the National Health Service (NHS) and private health provider, Bupa, it has also cemented its presence across the flourishing Chinese market, with a membership base exceeding 1.4mn citizens across Europe, Asia and Africa. By partnering with global juggernaut Tencent, Babylon’s artificial intelligence system has enabled both parties to interact directly with users, identify specific illnesses, deliver health status assessments, and triage necessary actions. The mobile app is available to over a billion users and linked to more than 38,000 medical facilities in China alone. w w w.he a l t hc a re gl o b a l. com

T O P 10

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Artificial intelligence Artificial intelligence (AI) applications, such as predictive analytics for patient monitoring has provided significant financial savings. Applications that target hospitals and medical institutions include patient monitoring and transcribing notes for electronic health records (EHRs).

The European Union is set to invest $24bn into artificial intelligence (AI) by 2020 in a bid to catch up with Asia and the US, who have invested heavily in AI and cloud services. This year, Google revealed its plans to harness AI and machine learning across a multitude of consumer technologies, particularly in healthcare. “If AI can shape healthcare, it has to work through the regulations of healthcare. In fact, I see that as one of the biggest areas where the benefits will play out for the next 10-20 years,” Google CEO Sundar Pichai has previously stated.

DECEMBER 2018

Blockchain

65

Blockchain is estimated to reach over $5.61bn by the end of 2025, even though it remains dependent on the ability to record and store information conveniently, economically and securely amongst different applications and systems. Providing transparency and eliminating thirdparty intermediaries, processes are streamlined, reducing healthcare costs exponentially. Unlocking the ability for providers to deliver a value-based healthcare system and enhance patient engagement, blockchain could save the industry up to $100-$150bn per year by 2025 in data breach-related costs, IT costs, operations costs, support function costs and personnel costs, according to BIS Research.

Partnering with pharmaceutical giant GlaxoSmithKline (GSK), Ethereum blockchain-based supply chain platform, Viant sought to accelerate the pace of blockchain-based supply chain systems. Accenture and supply chain giant DHL have also developed a blockchain-based serialisation prototype which tracks pharmaceuticals from the point of origin to the consumer. w w w.he a l t hc a re gl o b a l. com

T O P 10

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Health wearables With the rise of lifestyle diseases, such as diabetes, more consumers are turning to health wearables that monitor glucose, heart rate, physical activity and sleep to gain a greater understanding of their health conditions. Following on from the release of the first Bluetooth headset back in 2000, the growing interest in wearables has seen monitoring our health and data become standardised. This data can be analysed by sophisticated algorithms to drive long-term diagnosis and support. Partnering with Google, health wearables company Fitbit is exploring the development of consumer and enterprise health solutions. Its acquisition of HIPAA-compliant health platform, Twine Health has seen the business enhance its clinical services by bringing on board a coaching platform, empowering people to seek better health outcomes.

DECEMBER 2018

67

Electronic health records tools From 2018-2022, the electronic health records (EHR) market is expected to grow at a compound average rate of 6% per year Providers and organisations continue to house fragmented technologies which create barriers towards collaboration and data sharing opportunities. This is further exacerbated if a patient straddles both public and private healthcare. Technology giant Apple has integrated patients’ medical records into its Health App as part of its iOS 11.3 beta. The data is encrypted and protected with the user’s iPhone passcode. Partnering with hospital providers and clinics, patients are now able to view their medical records from multiple providers within one platform. Johns Hopkins Medicine, Cedars-Sinai, Penn Medicine, UC San Diego Health and even the Cleveland Clinic have implemented this technology. w w w.he a l t hc a re gl o b a l. com

T O P 10

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Healthcare transportation Non-emergency health transportation remains a key issue worldwide, preventing patients from getting to or from a doctor’s appointment. 25% of lower-income patients have missed or rescheduled appointments due to lack of transportation, costing US health systems up to $150bn each year. Transportation companies such as Lyft and Uber have therefore entered the market by partnering with state governments to reduce these costs and deliver personalised patient care.

DECEMBER 2018

69

3D Printing Healthcare providers are set to represent the second largest industry sector in 3D manufacturing. The Food & Drug Administration’s decision to release its first comprehensive framework advising manufacturers of 3D medical products highlights its growing impact where more than 100,000 knee replacement surgeries are completed each year using 3D-printed, patient-matched surgical guides, for example. Through this process, surfaces and structures can be optimised for strength, weight and material use. Consultation between surgeons and patients has also been bolstered, where patients can better understand the complexity of his or her specific needs.

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Genomics As consumers get more involved in the management of their health, consumer genetics and research companies have grown in popularity and scale. People want to further understand their genetic makeup, leading personal genomics and biotech company 23andMe to become one of the largest consumer-based organisations worldwide. Interestingly, this year, the company has entered a four-year collaboration with GSK to develop new treatments, but using human genetics as the basis for discovery.

70

Not only looking to develop treatments by analysing human genetics, pharmaceutical companies are looking to even remove hereditary genes which pass diseases down generations. In 2017, human embryos were successfully ‘edited’ through gene editing tool, CRISPR (Clustered, Regularly Interspaced, Short Palindromic Repeats), eradicating hypertrophic cardiomyopathy within 42 embryos.

DECEMBER 2018

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DECEMBER 2018

01

73

Vertical integrations As healthcare providers aim to provide greater transparency, promote collaboration and lower escalating patient costs, 2018 has been the year for a significant number of vertical integrations. CVS Health’s $68mn takeover of health insurer Aetna is a case in point. By influencing more of the supply chain, it will gain significant negotiating power to reduce costs for payers and patients, develop personalised solutions and improve overall outcomes. It will also promote the eradication of delays in process by removing any third parties within traditional business models. Other notable integrations are Optum’s acquisition of the DaVita Medical Group, Humana and Kindred Healthcare and Cigna and Express Scripts.

Reports have indicated that not only has the number of healthcare deals more than doubled in the last five years, the size of deals has also grown as a result of repeat investor interest, highlighting that this trend is here to stay.

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EVENTS & A S S O C I AT I O N S

The biggest industry events and conferences from around the world WRITTEN BY CATHERINE STURMAN

74

08­–11 JANUARY, 2019

Digital Health Summit [ SANDS EXPO, LAS VEGAS, USA ] Digital Health is a driving force in how

way. With over 55,000 sq ft dedicated

healthcare is administered, customised

to digital health, there is no shortage of

and reimagined. As the healthcare

cutting-edge innovations on display.

industry, policy makers, entrepreneurs,

Experience and interact with the latest

patients and business world navigate

technologies advancing modern medi-

through highly complex and unpredict-

cine, healthcare and wellness, including

able territories, it’s breeding revolutionary

digital therapeutics, artificial intelligence,

approaches, unprecedented partner-

sleep tech, condition-specific weara-

ships and ground-breaking solutions.

bles, precision medicine, virtual and augmented reality and so much more.

Digital Health – bold, boundless, fearless and optimistic – is showing the world it’s ready for whatever comes its

DECEMBER 2018

www.digitalhealthsummit.com

28–29 JANUARY, 2019

The 13th Annual Health Care Supply Chain Summit [ NEW ORLEANS, USA ]

75

Hospitals and healthcare organisations are in the midst of a revolution.

28–31 JANUARY, 2019

Using integrated delivery systems (IDS),

Arab Health

the health industry is moving towards

[ DUBAI, UAE ]

further digitisation to provide increased

Situated at the Dubai World Trade

efficiencies in the face of rising health-

Centre, Arab Health is set to welcome

care costs. The 13th Annual Health Care

more than 84,000 healthcare profes-

Supply Chain Summit will aim to explore

sionals from over 160 countries. The

key topics, such as driving savings

event will deliver key insights, with 11

across the supply chain, whilst optimis-

CME accredited conferences availa-

ing contracting, logistics and value

ble, showcasing new technologies,

analysis, fully eradicating inefficiency

procedures and transformations within

across the healthcare supply chain.

the healthcare sector..

www.worldcongress.com

www.arabhealthonline.com

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EVENTS & A S S O C I AT I O N S

76

11–15 FEBRUARY, 2019

Healthcare Information and Management Systems Society (HIMSS) 2019 [ ORLANDO, USA ] One of the most iconic healthcare

event will bring together IT and health-

events in the 2019 calendar, the HIMSS

care professionals to provide essential

Annual Conference provides thought

learning from world-class speakers,

leadership, community building, public

who will discuss the cutting-edge digi-

policy, professional/ workforce devel-

tal health products of the future. Key

opment and engaging events to over

topics span clinical informatics and cli-

70,000 global individual members, 630

nician engagement, consumer, patient

corporate members, and over 450 non-

engagement and digital health, cyber-

profit organisations.

security, disruptive care models, precision medicine and more.

Serving the global health information and technology industry, this year’s DECEMBER 2018

www.himssconference.org

18–19 MARCH, 2019

5–7 MARCH, 2019

World Healthcare Congress Europe

Future Healthcare 2019 Exhibition & Conference [ OLYMPIA, LONDON ]

[ MANCHESTER CENTRAL, UK ]

The Future Healthcare 2019 Exhibition

Exploring the next era of health and

& Conference will welcome over 4,000

social care across Europe, the World

attendees from 65 countries, where

Healthcare Congress will aim to reduce

experts will seek to address some of

rising healthcare costs and look at

the biggest problems presently facing

ways to transform the delivery of

the industry. An event for both public

health and social care transforming

and private sector organisations, the

both areas against growing patient

event will bring policy makers, buyers

expectations. As the industry faces

and practitioners together to overhaul

a number of challenges, placing incre-

traditional ways of working. Large cor-

ased strains on resources within health

porations can also meet with entrepr-

and social care, the congress will bring

eneurs and healthcare start-ups, share

forth key speakers, enabling cross col-

knowledge and learn from experts

laboration with like-minded individuals.

in the field.

www.europehealthcare.org

www.futurehealthcareuk.com

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EVENTS & A S S O C I AT I O N S

18–20 MARCH, 2019

Phar-East 2019

[ SUNTEC CITY, SINGAPORE ] 2018 debut, Phar-East will once again

The 16th Annual World Health Care Congress

bring together experts from Asian phar-

[ WASHINGTON, DC ]

ma and biotechs, big pharma, regulators,

Designed to meet the needs of profes-

payers, technology innovators and

sionals, from providers, payers and

more to share their expertise and chart

employers, to life sciences and policy

Asia’s path forward. Across two days,

organisations, The Annual World Health

explore four of the most exciting areas

Care Congress is in its 16th year, and is

of Asian pharma:

set to welcome over 2,000 attendees,

• Immunotherapy

with over 350 speakers in attendance

• Market access

in 2017. Catering to a vast ecosystem,

• Regulatory affairs

its agenda will ensure care delivery and

• Pharma 4.0.

payment transformation remains cen-

Brand new for 2019, there will be a clin-

tral, as leading experts share strategic

ical trials and biotech investment track,

initiatives, promote networking oppor-

giving you insights into this rapidly

tunities and enable attendees to hear

growing market. Phar-East is the pre-

about a broad range of topics across

mier meeting place for senior executives

four days from a multitude of passion-

from Asia’s pharma and biotech indus-

ate and diverse C-Level figures.

try. If you want to identify opportunities

www.worldcongress.com

Returning in 2019 after a successful

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28 APRIL– 01 MAY 2019

in Asia for your business…

www.terrapinn.com DECEMBER 2018

8–9 MAY 2019

11th Asia Pacific Global Summit on Healthcare [ TOKYO, JAPAN ] This year’s theme for the Asia Pacific Global Summit is set to explore ‘lead-

21 MAY–23 MAY 2019

ing innovation for better healthcare

Paris Healthcare Week

and nursing systems,’ attracting world

[ PARIS, FRANCE ]

class speakers and experts from

Attracting 30,000 visitors in 2018, Paris

social healthcare universities, clinical

Healthcare Week is known for attract-

research associations, expository

ing world-class speakers and for its

associations and Healthcare ventures.

leading trade shows, exploring digital

Exploring new healthcare strategies

technologies, how to transform tradi-

and opportunity for networking, the

tional hospital services and more.

event is set to house 1,000 events in

This year, the event will explore themes

two days, with 1,200 workshops also

such as e-Health, blockchain and

on offer, delivering essential insights

sustainable development, attracting

and key skills across the industry.

visitors worldwide.

www.healthcare.global-summit.com

www.parishealthcareweek.com

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DIGITISING THE PATIENT EXPERIENCE

With its lead hospital accredited by Joint Commission International for its high quality healthcare, Group CIO, Brett Medel, discusses how digitisation will prepare TMC for the future WRITTEN BY

CATHERINE STURMAN PRODUCED BY

MIKE SADR

DECEMBER 2018

A S I A PA C I F I C

81

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H

ealthcare leader in the Philippines and the owner of the first private

hospital in Guam, The Medical City (TMC) provides cutting-edge health services, housing centres of excellence in wellness and aesthetics, cardiovascular, cancer and regenerative medicine. The company has recently embarked on launching seven new institutes, which will cover a number of common health problems within the country.

With one flagship healthcare complex in Manila, four provincial hospitals, 50 clinic sties in Metro Manila and in select provinces 82

in the Philippines, a clinic in Dubai and a hospital in Guam with a total bed capacity of almost 2,000 beds, TMC has looked to fully digitise its operations to adhere to its philosophy – ‘Where patients are partners.’

With over 30 years expertise in the IT space, Group Chief Information Officer, Brett Medel is set to take the organisation to new heights. Through its digital transformation, Medel will establish best practices and ensure TMC retains its position as the healthcare provider of choice.

“TMC has been serving the Filipino community for 50 years, and it is considered a legacy institution. However, it has been saddled with a traditional front and back office system. It needs to transform to cater DECEMBER 2018

A S I A PA C I F I C

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The Medical City Critical Care experts Dr. Jose Emmanuel Palo and Dr. Jude Erric Cinco go over a patient’s X-ray while discussing his current condition.

w w w. h e a l t h c a r e g l o b a l . c o m

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A S I A PA C I F I C

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to the needs of the new generation so it has invested heavily across its digital journey to significantly improve the patient experience,” he says.

“My charter is to make TMC closer to the Filipino community as much as possible; to positively impact the patient experience

A TMC vascular technician and a consultant perform a Carotid Doppler test on a male patient.

A Carotid Doppler test is a safe and painless procedure that uses sound waves to examine the blood flow through the carotid arteries.

and improve on efficiency by building an interconnected ecosystem of stakeholders into a single platform.”

GIVING PATIENTS CONTROL Empowering individuals is something which TMC will strive to achieve through open communication and the use of new digital tools. w w w. h e a l t h c a r e g l o b a l . c o m

“From finding out the treatment for

in the hospital or clinic, as we believe

a particular disease, setting an appoint-

that healthcare is all about providing

ment with a doctor of choice, to being

premium quality of health; starting from

informed of the choices available for

prevention and awareness to ultimately

the type of wellness required is aligned

improving the health of every individual.”

with our value proposition of ‘Patients as Partners,’” adds Medel.

DIGITAL ROADMAP

“We see every individual not as

Providing a digital roadmap, TMC will

merely as a clinical patient, but a part-

partner with like-minded companies

ner who belongs to the ecosystem of

to drive essential change across its

wellness and health management.”

operations.

“TMC looks after the welfare of every windividual even before they set foot

“I always tell my people and my partners, ‘implementing a system is

86

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A S I A PA C I F I C

Laboratory technicians at The Medical City’s Regenerative Medicine Laboratory perform the engineering of cells and other biomaterials for the purpose of preserving, restoring, or enhancing organ function.

87

not the end result,’” reflects Medel. “However, to me, the criteria of success of any technology project is getting users to adopt the system.”

With the aim to bring the entire the network of hospitals and clinics under one platform, TMC has implemented a robust cloud infrastructure that can not only cope with the demands of the business, but deliver resilience across its disaster recovery strategy.

It will also work to ensure scalability.

“By getting all areas interconnected, we can maximise synergies across the hospital

“ By getting all areas interconnected, we can maximise synergies across the hospital network, without placing increased investment at each site” — Brett Medel, Group Chief Information Officer

network, without placing increased investment at each site,” says Medel. w w w. h e a l t h c a r e g l o b a l . c o m

E X E C U T I V E P R OF IL E

Brett Medel has been in the

88

IT profession for the past 30 years where 17 years were spent as CIO of various companies in the private sector. Prior to joining The Medical City, Brett served as Group CIO of ePLDT. As Group CIO of ePLDT, he wore two hats - “Internal facing” where he drives the digital transformation journey of the ePLDT, and “External facing” where he engages with the clients to help them in their strategic IT initiatives. He used to be the Chairman of the CIO Council of the MVP Group of companies with

DECEMBER 2018

30 CIO/IT Heads of member companies worked with him to bring about synergy through various IT initiatives of the MVP Group.

Prior to joining ePLDT his experience cuts across various industries like mining, manufacturing, government, retail, and insurance. He used to be the Vice President and Chief Information Officer of Philex Mining Corporation (a member of the MVP group of companies) since 2012. He spearheads major business transformation initiatives in Philex to improve operational effi-

A S I A PA C I F I C

By appointing Orion Health Inc, TMC has

ciency. Prior to joining Philex, he was the VP and CIO of Prudential UK and PNB Life. His IT exposure started way back in 1987 where he joined Andersen Consulting (now Accenture) as a management consultant where he held projects here and abroad for both the financial and manufacturing industry.

Brett holds a Bachelor of Science degree in Management Engineering (Honors Program), Ateneo de Manila University.

also invested in a world-class hospital information and consultation system, which will integrate with its other ancillary subsystems.

Nonetheless, the organisation is facing a number of regional challenges.

“We have server-based and networkbased applications, but capability is always complex,” comments Medel.

“To bring all of this into the cloud is the start of our transformation. At the end of the day, it’s all about bringing different players into an interconnected ecosystem.”

89

PROMOTING ACCESSIBILITY With so many hospitals and clinics situated over a vast geography, connectivity will also present fresh challenges.

Strengthening the wi-fi within its hospitals and clinics will become fundamental for TMC to capture data across a number of platforms, particularly mobile, in order to draw insights, trends, associations, sentiments, psychographics and more, in order to develop new programmes and services.

“Our digital transformation is not just about automation, but a shift in mindset by introducing new business models to raise the bar of the customer experience. It is about strengthening the company’s value w w w. h e a l t h c a r e g l o b a l . c o m

proposition to the next level,” adds Medel.

With this in mind, TMC is undergoing a significant initiative to build on its strong digital marketing strategy to bring the brand into the digital space. This will not only boost the organisation’s foot traffic, but further its digital footprint across a number of touchpoints, such as Facebook, Twitter and Instagram.

“We have shifted our marketing resources to put equal emphasis on digital marketing as to that of traditional marketing. This is a strategy that has never been before done in the entire history of TMC,” says Medel.

90

“TMC aims to top the charts on customer awareness across its products and services. We would also like to get the pulse of the digital community by conducting social listening and see how we are performing as a healthcare provider in the eyes of the digital community.

“Social media and mobile apps are sources of information that we can immediately collate and process, where either immediate feedback is given or immediate action is taken. This way, customers feel that they are valued and their feedback is taken on board.”

ENGAGING ALL PARTIES By deploying IT account managers across DECEMBER 2018

“ We see every individual not merely as a clinical patient, but a partner who belongs to the ecosystem of wellness and health management” — Brett Medel, Group Chief Information Officer

A S I A PA C I F I C

A Wellness doctor checks on a patient inside an Executive Suite at the Wellness and Aesthetics Institute.

91

the organisation, TMC has built a cul-

Moving forward, Medel remains

ture of innovation among its employees

keen to explore new avenues and

and medical staff, where it has gained

unlock further potential which has yet

a greater understanding from various

to be explored.

teams on what is required from a digi-

“TMC will be on this digital journey for

tal perspective to enhance the quality

the next couple of years,” he concludes.

of patient care.

“We need to make everyone aware

“We will be on top of AI, chatbots and of course, cloud. However, the most

of the benefits and the value of digital,

important aspect is having a robust

of being a part of the digital economy,”

community drive. This will remain the

acknowledges Medel.

focal point for TMC.”

“Not only medical staff or users, but also our stakeholders. Education is essential while we undertake our digital journey.” w w w. h e a l t h c a r e g l o b a l . c o m

Championing leading supply chain practices at UCSF Health With robotics, automation, new processes and more, UCSF Health is setting new standards for healthcare with its innovative supply chain WRITTEN BY

LAURA MULLAN PRODUCED BY

DENITR A PRICE

DECEMBER 2018

w w w. h e a l t h c a r e g l o b a l . c o m

U C S F H E A LT H

U

CSF Health is at the forefront

– that’s when he realized how trans-

of healthcare innovation but,

formative technology could be.

behind the scenes, the group’s Medical Center supply chain team are keeping

rote and rudimentary tasks every day,”

the cogs turning so it can focus on

he notes. “I began to realize that with

delivering the state-of-the-art care it is

the help of our Materials Management

known for.

Information Systems Team (MMIS Team)

UCSF Medical Center was recently named among the nation’s premier medical institutions for the 17th consec-

94

“I found myself doing the same set of

we could automate a lot of the procurement activity I was encountering.”

Automation has become a prevalent

utive year, standing as the fifth best

trend in the supply chain field and it

hospital in the country and the top-

hasn’t gone amiss at UCSF Health. In

ranked hospital in California, accord-

2009, Limbert and his team partnered

ing to US News & World Report’s

with Global Healthcare Exchange

2017-2018 Best Hospitals survey.

(GHX) to develop tools that allowed

In the back-end, its supply chain

his team to onboard vendors who

team is responsible for a comprehen-

would then receive their purchase

sive set of services that continually

orders (POs) in a highly-automated

strengthen the scope of its patient

and accurate fashion.

care. The organisation provides access

“A requester at the hospital could

to a broad range of medical-surgical

scan an order or put through a request

products, and consistently seeks to

and that would queue up a requisition

reduce supply chain waste and expens-

that would be turned into a purchase

es but, above all else, it is committed

order automatically without any buyer

to delivering quality customer service,

intervention,” explains Limbert. “We

which enables premium care.

call it ‘no touch POs.’

When he began as a buyer in procure-

“We were able to do that on a fairly

ment almost 16 years ago, Jake Limbert,

large scale. We have about 600 POs

now Director of Supply Chain Operations,

that go out every day and so we were

did many menial and repetitive tasks

really able to take our PO activity and

DECEMBER 2018

USA

95

FACT

There are 600,000 pieces of product onsite at all times

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USA

“ If we can empower our clinicians to provide better care then we can also grow with them in a way that’s meaningful” — Jake Limbert, Director of Supply Chain Operations

UCSF Medical Center at Mission Bay opened, aiming to set new standards for healthcare in the 21st century.

The 289-bed complex features three separate hospitals, specialized in serving children, women and cancer patients.

With such a mammoth operation, Limbert and his team wanted to focus on automation and streamlining operations where possible.

With the latest wave of innovation, it seems robotics are redrawing the healthcare landscape. Keen to tap into

just turn it into an automated process.

this emerging trend, UCSF Health

At that point, we could also hard code

teamed up with Aethon to use its

shipping and logistical standards with

autonomous mobile TUG robots. These

all of our vendors so they knew that

new-generation robots allow UCSF

UCSF had an exact and predictable

Health to distribute items easily and

timeframe to deal with.”

reallocate their workforce so team

Building on this partnership, GHX then built Registration Center, otherwise known as ‘RegCenter’ which

members can focus on value-adding tasks rather than repetitive jobs.

“This was revelatory as it allowed us

allowed UCSF Health to onboard its

to reallocate our full-time equivalent

own vendors. As a result of its efforts,

(FTE) resources,” said Limbert. “We also

UCSF was later recognized by GHX

utilize the TUGS for our soiled linen

in 2011 with their first every Industry

pickup which helped us reduce employ-

Impact Award.

ee injuries because, given census and

Since then, Limbert and his team

patient volumes, these linen carts are

have continued on an upward trajec-

becoming increasingly unwieldy.

tory thanks to new and improved

Thanks to robotics we’ve been able to

technological innovations. In 2015, the

keep our employees in an area where w w w. h e a l t h c a r e g l o b a l . c o m

97

U C S F H E A LT H

CLICK TO WATCH : ‘UCSF OUR STORIES: RITE OF PASSAGE — A HOSPITAL PROM FOR TEEN PATIENTS’ 98 they’re most effective and appreciated.

cost-effective supply chain processes

They’re able to further support clinicians.”

whilst meeting the individualistic needs

Like many in the supply chain discipline, UCSF Health has worked to streamline

of the clinicians and patients alike.

“If they’re able to interact with clinicians

and standardize its processes, so that

in a meaningful way then that allows us

the medical professionals can focus on

to again, gain their trust,” explains

what matters — patient care. Every

Limbert. “We just don’t want people

patient’s healthcare needs are unique

stocking shelves, we want people to

and highly personalized.

engage the clinician and figure out their

Therefore, Limbert and his team

needs so we can make sure they are

worked closely with clinicians to establish

enabled to deliver the highest quality

their needs and maintain the unparal-

of care.”

leled, innovative care UCSF is known

“There’s a certain level of expecta-

for. In doing so, the group has worked

tion that our clinicians demand and

to strike a balance between streamlined,

I think we are able to provide that by

DECEMBER 2018

USA

FACT

The UCSF Medical Center is the fifth best hospital in the county and the top-ranked hospital in California 99 empowering our employees to resource

that’s not really going to work because

and make decisions on their own. We

our cases start at 7:00 a.m. so we need

call them our ‘supply chain ambassadors.’

product replenished by 5:00am,’ for

We want them to be resources for the

example. In that case, we are able to

customers, not just inventory technicians.

scale it and tweak it for them.

“The real product for us is patient care.

“That is a challenge, however, it’s also

Every patient has a different set of needs

something that we relish. Every patient

and a clinical path unique to them.

is unique and they are our number one

“We are able to engage the end user,

priority. I think we have to be mindful of

the clinician, and say, ‘These are our

where we can standardize and where

schematics and this is our framework.

we can’t.”

Does this synch with your needs?’

The opening of the UCSF Benioff

Almost like a switchboard, we plug and

Children’s Hospital at Mission Bay was

slot them into our order of business.

not only a key milestone in the institu-

“Alternatively, they might say, ‘Well

tions’ history, but it also gave Limbert w w w. h e a l t h c a r e g l o b a l . c o m

U C S F H E A LT H

and his team a fresh slate to drive efficiencies and cost savings. In doing so, the team had two focuses: the first was the customer and the second was generating operational data.

“First, we determined, having learned from previous successes and failures, what the customer expected from us and what they needed in order to deliver the quality care that our patients deserve,” explains Limbert. “We were able to listen and figure out what worked and didn’t in the previous care area and then adapt and create new workflows, meaningful periodic automatic replenishment (PAR) levels and service level agreements (SLAs).

100

“Secondly, we built a very robust and intricate set of data,” he continues. “In order to achieve

“Every patient is unique and they are our number one priority” — Jake Limbert , Director of Supply Chain Operations

the previously established automation, we had to engage MMIS and our vendors to ensure the efficiencies would be mirrored in another facility.

“We devised new shipping locations and schedules aligned with our new docks for optimal transport up to the unit. For example, right now a technician will transmit an order and in less than 12 minutes the vendor will have it. They can pick it and then it will show up the next day at that room in fewer than 24 hours.”

With 78mn products delivered annually at UCSF, its supply chain operation is mammoth in scale. Now, as the organization expands,

DECEMBER 2018

USA

101

Limbert says the biggest challenge is

their piece within this dynamic jigsaw,

sustaining this growth.

it helps them feel more engaged and

“It’s a good problem to have in that the healthcare environment in the Bay Area

proud to provide a crucial piece in the patient care continuum.”

is very competitive but if we can empower our clinicians to provide better care then we can also grow with them in a way that’s meaningful,” notes Limbert.

“Allowing our ambassadors and staff to feel ownership over the care that we’re providing is vital. If you can illuminate w w w. h e a l t h c a r e g l o b a l . c o m

“With its variety of reliable wearables and interfaces, Garmin is an ideal partner for us.”

Gabi Zodik

CTO of IBM Watson IoT IBM Haifa Research Lab

DRIVING INNOVATION FOR DIGITAL HEALTH We provide partners with world class devices and offer access to Garmin User data through our Health API and SDKs.

garmin.com/health

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