1. Quality & technology
A blessing or a curse?
Unamec Symposium
27th October 2015
www.pwc.com
Erik Cotman
PwC healthcare management consulting

2. PwC
Quality – Qualité- kwaliteit
2
October 2015Quality & technology

3. PwC
Definition of Quality in healthcare
Effective, evidence based and results in
improved health outcomes for individuals
and communities, based on need;
Efficient, maximizes resources use and
where skills and resources are appropriate to
medical need;
Patient-centred, care taking into account
the patient wishes;
Accessible & Equitable, timely and
affordable health care which does not vary in
quality because of personal characteristics
such as gender, race, ethnicity, geographical
location, or socioeconomic status;
Safe, delivering health care which
minimizes risks and harm to service users.
Quality & technology
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October 2015
Relative
Cost
Healthcare
Value
Clinical Outcomes
Patient Centricity
Safety
+
+
Source: World health Organization guide “Quality of Care, a process for making strategic choices in health systems ”

4. PwC
Building blocks for Quality care
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Partnerships &
organisational
alignment
Value Based
Healthcare
Innovati0n
Risk management
Strategical &
Organisational
Efficient Resource
utilisation
Accreditation
Sustainable
cost reductions
Big Data &
Digitalisation
Middelen,
Mensen en
Organisatie
Sustainable
Quality
Care
Governance
&
Compliance
Strategy &
Business
Model
Healthcare
Value
Analysis
Integrated
care
Clinical &
Operational
Excellence
Risk,
Quality &
Financial
Assurance
Financial
Optimization
Technology
&
Data

5. PwC
Medical science and technology has advanced at a
rapid pace, did the health care delivery system
provide consistently high quality care to all?
Quality & technology
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October 2015
Providing Care, a balancing act
Projected increase in annual healthcare
expenditure (in billions) between 2010 & 2040 $200 $200$300
$3,500
UK Japan US Canada

6. PwC
Belgium is a microcosm of what’s happening
across the globe
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October 2015Quality & technology
Increase in chronic disease
Ageing population
Increasing system costs
Inefficiency and waste
Fragmentation of care
More volume than value
Consumerism
Reform/Talk of reform

7. PwC
Health care is at an important turning point to
ensure quality of care
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• 3 strengthsof the Belgian healthcare
system: (perceived) Quality, Accessibility and
Affordability;
• Risk: less affordability resulting in
potential loss of quality and accessibility to our
healthcare system;
• High expectations from our populations,
that are very well informed;
• Demographic (life expectancy, multi-morbidity),
economic (slow economic recovery), medical-
technical (innovation) developments put pressure on
our healthcare expenditure
• Structural reformsconsidered by our
policymakers (refinancing healthcare, Pay for
Quality,...)

8. PwC
Quality concerns the entire healthcare ecosystem
Quality & technology
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October 2015
Provider
Producer
(MedTech)
Payer
(Government)

9. PwC
Eliminate re-admissions or worse
Quality & technology
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October 2015

10. PwC
Enhanced patients Safety with full Traceability
IOM report
concluded yearly
> 50.000 people die
as a result of
preventable medical
errors with 7.000
due to medication
error. These errors
result in a 3,5 billion
$ cost in US alone
Importance of final check at the bedside
Prevent
adverse
events
Complete
identification
according to
standards is a
key element of
Sustainable &
Quality
healthcare
Right
medication
Right dose
Right
medical
device
Right
patient
Right time
Right route

11. PwC
Patient-centric
Quality & technology
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October 2015
www.pwc.com/thrivewithcancer

12. PwC
Bring back house call?
New York Times – 14 October
Quality & technology
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October 2015
Prevention
Beyond
Medical
diagnose

13. PwC
Growing needs for prevention
Moving from Healthcare to Health
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Source: PwC analysis (2014)
Fitness and wellness is a fast growing market across the globe
$1.49 trillion
total global ancillary/wellness
market size
$391B
Global nutrition
market
$236.5B
Sporting goods
and apparel
$595B
Weight loss
industry
$8.02B
Mobile
health apps
$114B
Alternative
medicine
$48B
Medical
tourism
$3.1B
Wearable
devices
$113. 4B
Natural &
organic foods
$109.5B
Supplements
$43B
Natural and
organic
personal care &
household products
$125.1B
Functional
foods
$19.4B
RPM/
Telemedicine
$78.4B
Global fitness
industry

14. PwC
US consumers are ready to abandon traditional
care models for more digital, do-it-yourself options
Percent of US respondents answering “Very likely” and “Somewhat likely” to consider these
alternatives:
Check for ear infection
using device attached
to phone
46.9%54.8%
Evaluation of minor
skin conditions
Ah
Use an at-home
strep test
58.6%
Source: PwC Health Research Institute, April 2014, “Healthcare’s New Entrants: Who will be the industry’s Amazon.com?”
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15. Digital is not a set of channels. It’s a cultural shift in behavior.
This is the new reality also in Belgium.
BEHAVIORAL SHIFT
15PwC

16. Digital Natives
make decisions to
engage or not in
1/20 of a second.
Sources: MillwardBrown, Nielsen Norman Group
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SENSOR
DRUG ELUTING DEVICE
SECONDARY DATA USE
Heart rate, blood glucose,
etc.
Patch, sensor,
watch
Trials, Watson
HealthyCircles
“CONNECTED” APPLICATION
INTERACTION HUB “INDIVIDUAL” APPLICATION
iPhone MyFitnessPal
ECOSYSTEM

17. Technology Investment – Show Me the Money
Slide 17
Source: Rock Health Funding Database

18. PwC
Blurring lines between traditional players
combined with Digital DNA from new entrants are
shaping new Digital Innovation Zones
Healthcare
providers
Government
Healthcare
payers
Pharmaceuticals
and life sciences
Retail and
consumer
Financial
services
Telco
Technology
ConsumerPrimary
Caregiver
Specialty
Caregiver
Family
Caregiver
Payer, Employer, other
risk-bearing entity
USERS
4
DIGITAL
INNOVATION ZONES
Care
Transparency
Digital Therapy &
Delivery
Care
Coordination

19. PwC
…and are being enabled and driven by
collaborative plays between pharma life sciences
and new entrant players
Teva Pharmaceuticals and IBM Partner to Build Global
e-Health Solutions on the IBM Watson Health Cloud
Proteus Digital Health and Otsuka Seek FDA Approval
for World’s First Digital Pill
Roche and Qualcomm join forces for next-gen remote
patient monitoring solution
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Biogen CEO says the biotech aims to develop wearable
and ingestible devicesWearables
Novartis to Begin Human Testing of Google’s Smart
Contact Lens in 2016

20. PwC
This fertile ecosystem is attracting diverse,
sophisticated new entrants into healthcare
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3 Telecom
7 Retailers
4 Finance
14
Traditional
Healthcare
Companies
24
New
Entrants
12
Non
healthcare
players
2 Automotive 3 Consumer Products
5 Technology
Fortune 50
Large Conglomerates Start Ups & Niche Players
Source: PwC Health Research Institute, April 2014, “Healthcare’s New Entrants: Who will be the industry’s Amazon.com?”
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21. Where do you want to be...
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22. PwC
MedTech needs new services and business models
to survive and grow, through radical innovation
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The Level of Innovation
The degree of technology and business
model change determine the level of
innovation.
MedTech companies should:
• Be ambidextrous;
• Collaborate to get
closer to the patient;
• Measure innovation
TechnologyChange
Business Model Change
Incremental
Break
through
Radical
Low

23. 23
Becoming the
disruptor, not the
disrupted.
Move Digital
Move Partnerships
Move Patient Centric
Move forward & provide Value
PwC
The term innovation needs redefining in an
environment that rewards VALUE –
measured in affordable patient outcomes
and customer satisfaction – over Volume.

24. PwC
Thank you
www.pwc.com/us/healthcarenewentrants
www.pwc.com/global-health
erik.cotman.rbr@be.pwc.com
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