Lars Kalfhaus
Country Manager Roche Diabetes Care (ES)
Connect, Engage and Take Decisions
Opportunities and Challenges of Telemedicine Implementation
EHiN 2014, IKT-Norge og HOD
24. Fundamental Global Trends – QUANTIFIED SELF
Nothing new for people with diabetes!
With the
installed base of
medical devices
Today > 500.000
data points
This
Week
> 3.500.000
data points
… Norway
26. No Significant Improvements in Diabetes Management
Diabetes
related drugs
and medical
devices
320 OADs
150 Insulins
10 GLPs
> 200 Med. Dev.
… despite access to and availability of
innovative pharmacological treatment options
27. Cost Burden as a Consequence of Suboptimal Diabetes
Management
Severe
x24
Moderate
Mild
General Population
x2
x6
Kaiser Permanente
Plan de Chronicos Navarra
• Promote health living,
prevention and good
health
• Avoid disease progression
and comorbidities
• Find adequate balance and
tools for integrating self-care
and professional care
Costs
28. The Promise of Telemedicine
Value = Health outcome
Cost of delivering the outcome
• Prevention
• Early detection
• Quality of Life
• Prevention of complications
• Less hospitalization
• Slower disease progression
• Faster recovery
• Fewer recurrences ...
… the enabling technology platform
Michael Porter; Redesigning Helathcare
29. Access, equity, quality
and cost effectiveness
Better health is the goal, not more
or less treatment
The Goal
Michael Porter; Redesigning Helathcare
Global Observatory for eHealth Series – Volume 2; who.int
30. Personalized Diabetes Management Cycle – Enabled by
Technology
Ceriello et al; Diabetes as a case study of chronic disease management with a personalized approach: the role of a
structured feedback loop; Diabetes Res Clin Pract. 2012 Oct
31. Key Considerations
… on the way to fully capture the Telemedicine promise
Organizational
Business Telemedicine Legal
Political
32. Business Considerations …
New Business Models needed
• Glocalization
• Interoperability
• Co-creation
• Integration
• Pricing and revenue
models
34. Organizational Considerations …
• Process and cultural change on how care is
delivered
• Alignment of KPIs and incentive schemes for
healthcare workers
• Development and acceptance of new study
designs (beyond classical clinical evidence) to
assess effectiveness
35. Political Considerations …
• Willingness to engage in co-creation and overcome
classical barriers and role definitions between
stakeholders
• Build confidence and trust between all stakeholders
• Coherent policy making that encourages competition
centered around patient value over the entire care
cycle
36. Legal Considerations …
… technology changes faster than legal
and regulatory framework
• Data protection, patient safety and privacy is a top priority
• Regulatory aspects: Medical Devices (classes) boundary
between MD and non regulated products – interoperability
between the two
Changes in contractual framework especially public sector
procurement and tender legislation
37. To Sum Up …
• The business potential of Telemedicine could be far
greater than generally estimated
• It will require (and enable) fundamental
restructuring of healthcare delivery
• Co-creating and collaboration between stakeholders
will be key in a value-creation approach on what the
technology should accomplish