Understanding The New Normal Of A Digital Society Focus

Deep Dive
Understanding The New Normal
Of A Digital Society
Focus: Healthcare / Pharma
Dr. Alexander Schachinger
CEO, EPatient RSD GmbH, Berlin
80 years of stagnation in the healthcare systems mass media paradigm
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2
The New Normal
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Eine digitale Gesellschaft mit neuen sozialen und ökonomischen Paradigmen
Vom proprietären zum Commons-Paradigma, vom Industrie- zum Informationsparadigma
Yochai
Benkler
© 2015 E Patient RSD GmbH, Berlin
Manuel
Castells
Jeremy
Rifkin
Clay
Shirky
Barry
Wellman
4
Results of a bottom-up ecosystem within regulated top-down industries
„“2,800 People with Acid Reflux Report Which Treatments Work Best”
© 2015 E Patient RSD GmbH, Berlin
5
Wisdom Of The Patient Masses for Medical / Tech. Innovation
© 2015 E Patient RSD GmbH, Berlin
6
The Digital Healthcare Market in a Nutshell
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
© 2015 E Patient RSD GmbH, Berlin
7
The Digital Healthcare Market in a Nutshell
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
3 to 4 thousand
health & medicine relevant
websites, communities,
apps
© 2015 E Patient RSD GmbH, Berlin
8
The Digital Healthcare Market in a Nutshell
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
3 to 4 thousand
health & medicine relevant
websites, communities,
apps
© 2015 E Patient RSD GmbH, Berlin
9
The Digital Healthcare Market in a Nutshell
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
Medical Internet Research
& EPatient Science
3 to 4 thousand
health & medicine relevant
websites, communities,
apps
© 2015 E Patient RSD GmbH, Berlin
10
Medical Internet Research – a global evolving research field,
most unknown in Central Europe and GER countries: Why?
JOURNAL OF MEDICAL INTERNET RESEARCH
Christensen et al
Review
in Internet Interventions for Anxiety and Depression:
Adherence
Systematic
Review
JOURNAL OF MEDICAL INTERNET RESEARCH
Linn et al
Helen Christensen, PhD, MPsych, BA; Kathleen M Griffiths, PhD, BSci; Louise Farrer, BPsych
Review The Australian National University, Canberra, Australia
Centre for Mental Health Research,
Corresponding Author:
Effects of eHealth Interventions on Medication Adherence: A
Helen Christensen, PhD, MPsych, BA
Systematic
Review of the Literature
Centre for Mental Health
Research
Australian National University
Canberra ACT 0200
Australia
Annemiek J Linn1, MSc; Marcia Vervloet2, MSc; Liset van Dijk2, PhD; Edith G Smit1, PhD; Julia CM Van Weert1,
PhD
Phone: +61 2 6125 8409
Fax: +61 2 6125 0733 1Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
2
Netherlands Institute for Health Services Research, Utrecht, Netherlands
Email: [email protected]
Corresponding Author:
Marcia Vervloet,
MSc
JOURNAL OF MEDICAL INTERNET
RESEARCH
Abstract
Anhøj & Nielsen
Netherlands Institute for Health Services Research
P.O. Box 1568
Original Paper
BN which deliver cognitive and behavioral interventions for anxiety and depression are
Background: OpenUtrecht,
access3500
websites
JOURNAL OF MEDICAL INTERNET RESEARCH
Netherlands
characterised by poor adherence.
We2729713
need to understand more about adherence in order to maximize the impact of Internet-based
Phone: 31 30
Original Paper
interventions on the disease
associated with common mental disorders.
Fax: 31burden
30 2729729
Email: [email protected]
van Gaalen et al
Quantitative and Qualitative Usage Data of an Internet-Based
Asthma Monitoring Tool
Objective: The aims of this paper are to review briefly the adherence literature with respect to Internet interventions and to
Long-Term
Outcomes
of Internet-Based Self-Management Support
investigate
the rates
dropout
and, MA,
compliance
in randomized controlled trials of anxiety and
depression Web
studies.
Jacob
Anhøj , MD,
DIT; of
Lene
Nielsen
PhD Student
Abstract
in Adults
Asthma:
Methods:
A systematic
review
of randomized
controlled trials using Internet interventions
for anxietyWith
and depression
was Randomized Controlled Trial
AstraZeneca
A/S, Business
Communication,
Albertslund,
Denmark
1
2
1
2
Copenhagen
Business
of Informatics,
Frederiksberg,
Denmark
Background:
medication
nonadherence
is considered
to be anand
important
risk, numerous
conducted,
andSchool,
dataDepartment
was
collected
onSince
dropout
and adherence,
predictors
of adherence,
reasonshealth
for dropout.
interventions to improve
adherence have been developed. During the past decade, the use of Internet-based interventions to improve medication adherence
Corresponding
Results: Author:
Relative tohas
reported
rates
of dropout
open access
sites,
the present
study
foundL that
the rates
ofThijs
attrition
in and situation
Johanna
van
MD;
MD; Victor van der Meer, MD, PhD; Patricia van Reisen, MD; Geertje
increased
rapidly.
Internet from
interventions
have the
potential
advantage
of
tailoring
the Gaalen,
interventions
to
theBeerthuizen,
needs
Jacob Anhøj, MD, DIT
randomized
controlled
trials
were
lower,
ranging
from
approximately
1
50%.
Predictors
of
adherence
included
disease
severity,
W
Redelijkheid,
MD;
Jiska
B
Snoeck-Stroband,
MD, PhD; Jacob K Sont, PhD; SMASHING Study Group
of
the
patient.
AstraZeneca A/S
Center,
Department
of Medical
Decisionin
Making, Leiden, Netherlands
treatment
length, and chronicity.
few
studies
examinedreview
reasons
fortodropout,
andLeiden
mostUniversity
studies
failed
to use
appropriate
Business
Communication
Objective:Very
The
main
aim formally
of this systematic
was
investigate
which
tailoredMedical
Internet
interventions
are effective
Roskildevej
22
improving
medication
adherence.
statistical techniques to analyze missing data.
Corresponding Author:
DK-2620 Albertslund
Jacob K Sont,EMBASE,
PhD
Methods: We undertook comprehensive literature searches in PubMed, PsycINFO,
CINAHL, and Communication
Conclusions: Dropout
rates
from
randomized
controlled
trials
of
Web
interventions
are
lowUniversity
relative
to
dropout
from open
Denmark
Leiden
Medical
Abstracts, following the guidelines of the Cochrane Collaboration. The methodological
quality
of theCenter
randomized controlled trials
Phone:
+45 E
43666275
11
© 2015
PatientThe
RSDdevelopment
GmbH, Berlin
of Medical
Decision Making
access
websites.
of theoretical models of adherence is as important in theDepartment
area of Internet
intervention
research
and clinical controlled trials and methods for measuring adherence were independently reviewed by two researchers.
The Digital Healthcare Market in a Nutshell
© 2015 E Patient RSD GmbH, Berlin
12
Global Scietific Best Practice Of Web-based Interventions
© 2015 E Patient RSD GmbH, Berlin
13
The Digital Healthcare Market in a Nutshell
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
Medical Internet Research
& EPatient Science
3 to 4 thousand
health & medicine relevant
websites, communities,
apps
© 2015 E Patient RSD GmbH, Berlin
14
The Digital Healthcare Market in a Nutshell
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
Medical Internet Research
& EPatient Science
3 to 4 thousand
health & medicine relevant
websites, communities,
apps
© 2015 E Patient RSD GmbH, Berlin
15
3. Results: Therapy: Medication:
Effects of digital services in the focus of medication
10%
I can understand my doctor's instructions concerning my
medication much better now and follow it more easily.
I changed the dosage or combination of my medication
myself.
30%
34%
I can handle my medication and the regular intake of it
much better now.
Because of my use of the internet or apps my doctor
prescribed me a different kind of medication.
20%
40%
! 31%
14%
12%
Base: n=2663 (all except interested parties,
average value of "applies" and "partially applies" 0%
Core result: It illustrates the potential of digital intervention for a therapy or medication adherence which so far has been
applied or researched in a majorly unregulated, non-evaluated, structured way (concerning the first two items).
In reverse, this dynamic also shows its effect on prescription and dosage behaviour of doctor and patient.
EPatient Survey 2015 Data, Product License for (Customer)
© 2015 E Patient RSD GmbH, Berlin
16
3. Results: Therapy: Medication:
Desired source for receiving digital medication services
0%
20%
40%
From my doctor
57%
From my health insurance
38%
I want to look for them myself online.
Base: n=2663 (all except interested parties) 25%
From a mail-order pharmacy
From my hospital
! 28%
From a patient organisation
From the manufacturer of my medication
60%
19%
17%
8%
Core result: In view of two so far separately existing "parallel worlds": traditional healthcare system with support
structures and 40 million German "health browsers" online versus approx. 8000 healthcare websites, communities
and apps, the question of how to merge these two worlds, becomes pressing. Answer items 1 and 2 might be
pointing the way ahead.
(Background: http://epatient-rsd.com/marktanalyse-digitaler-gesundheitsmarkt/ )
EPatient Survey 2015 Data, Product License for (Customer)
© 2015 E Patient RSD GmbH, Berlin
17
3. Results: Therapy: Medication:
Mentioned improvements/ideas for digital medication services
20%
Understandability, Usability
39%
Trusted Source, Transparence of Information
Personalized Information on Medication
Combination Effects
40%
19%
60%
! Base: n=1087 open text entries (summarized categories) 0%
17%
Search, Compare on Similar Substances and
Package Sizes
8%
Every Day Life Best Practice on behalf my
medication Intake (Sports, Food, Stress)
5%
Personalized Information on Dosage and Intake
5%
Key message. There is reason to suspect that a critical mass of services fail in their usability and comprehensibility
and thus do not deliver their desired (therapeutic) effect.
This aspect is a core area which clearly has not been examined enough in respects to its potential, although it bears
effect potential (see examplatory: http://www.jmir.org/2012/6/e152/ ). The improvement of comprehensiveness and
usability is ranking first place in all following therapy-specific ideas for improvement.
EPatient Survey 2015 Data, Product License for (Customer)
© 2015 E Patient RSD GmbH, Berlin
18
Results of a bottom-up ecosystem within regulated top-down industries
„“2,800 People with Acid Reflux Report Which Treatments Work Best”
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
Medical Internet Research
& EPatient Science
New
3 to 4 thousand
Generation Of
health & medicine relevant
Digital Health
websites, communities,
Startups
apps
© 2015 E Patient RSD GmbH, Berlin
19
Results of a bottom-up ecosystem within regulated top-down industries
„“2,800 People with Acid Reflux Report Which Treatments Work Best”
40 Mio.
Healthcare-surfers
& epatients
Traditional
Healthcare System
(1st Healthcare
Market)
Medical Internet Research
& EPatient Science
New
3 to 4 thousand
Generation Of
health & medicine relevant
Digital Health
websites, communities,
Startups
apps
© 2015 E Patient RSD GmbH, Berlin
20
2. Der Gesamtmarkt Kommentar: Starke Reichweiten-‐
konzentraFon mit einem „Long Tail“ an vielen themaFsch diﬀerenzierten Webseiten mit kleineren Reichweiten. Reichweiten großer Publikumsportale wurden lediglich im Rahmen ihrer Gesundheitsinhalte berechnet. Fazit: Detailanalyse für IndikaFonen, Themen, Sonderzielgruppen für eﬀekFve Mediaplanung sinnvoll. Basis: n= 11.880 Webseiten Alle Gesundheitswebseiten nach monatlicher Reichweite (Ausweisung immer in BruMo-‐Reichweiten) Besuche/Monat in Mio. 3,0#
2,5#
2,0#
1,5#
1,0#
Top 400 0,5#
0,0#
DGM REPORT DATA 2014 BASIS Dokumentlizenz für: Kundenname © 2014 EPaFent RSD GmbH, Berlin 11.880 Webseiten 13 Evolution of Health 2.0 Non Traditional Startups Entering The Traditional Healthcare
Ecosystem
© 2015 E Patient RSD GmbH, Berlin
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Aufbau und Entwicklung DGM Report 2015 – Digitale Gesundheits-Startups
Phase 1
2000–2008
(stationäres Internet)
Entwicklung
Unternehmen
Anwendungen
Phase 2
2008–20012
(Mobile Apps und erste neuen Dienste)
Manuelle Datensammlung
via App
Fitness- /
Bewegungs-Tracker
Phase 3
2013–2015
Tracking via
Wearables (1)
X
O
Erste E-Learning
Angebote
Big Data
Tracking /
Echtweltdaten
DATENSAMMLUNG /
TRACKING
Medizinisches Tracking
(manuell + via Wearables)
Individualisiertes
Coaching (Information
Therapy) (1)
Coaching als Versicherungsleistung
E-COACHING
Tailored Coaching basierend individualisiertem
Echtwelt-Feedback
Digitale Apps
Erste Versuche von OnlineGesundheitsakten
Unabhängige Online Akte
Vernetzte Online Akte
PERSONAL HEALTH
RECORD
Webseiten, Portale, Communities, E-Commerce,
Verzeichnisse
Arzttermine Online
Kleinere Daten/Anamnese
Services
Online Arztsprechstunde (1)
ARZT-PATIENT-DIENSTE
(LEISTUNGSERBRINGER)
Arzt/Klinik Empfehlungen /
Verzeichnisse
Bottom-Up Bewertungsportale
Erste Apps für Chroniker,
Medikamente, Verlaufstagebücher, manuell (2)
Erste SymptomChecker, DiagnoseApps, Risiko-Rechner
Zweitmeinung
MedikamentenManagement
Daten-Management/ Apps
für Medizingeräten
Diagnostik basierend
Angaben
Fusion von Klinik-IT mit
Patienten-Service auf
Patienten-Smartphone (2)
Medikamenten-App in
Vernetzung mit Apothekenmarkt
Digitale Adhärenz
Forschung
ANWENDUNGEN FÜR
MEDIKAMENTE UND
MEDIZINGERÄTE
Mobile / Automatische
Diagnostik
INTERNETBASIERTE
DIAGNOSTIK
Laborbasierte Diagnostik
Content und Community
Tailored
Content+Community
Neue Formen von
Infotainment / Aufklärung
CONTENT + COMMUNITY
Weisheit der Massen
© 2015 E Patient RSD GmbH, Berlin
23
Case: Arya
Smart Real World Data Transformed into Medicare Research Data and Outcome Research
© 2015 E Patient RSD GmbH, Berlin
24
Case: Xbird.io
3rd Apps Smartphone Usage Converged Into Early Prevention And Early Sickness Patterns
© 2015 E Patient RSD GmbH, Berlin
25
Case: Medisafe
A virtual Pillbox including Reminders To Close Caregivers
© 2015 E Patient RSD GmbH, Berlin
26
Evolution Of Basic Web-based Paradigms
Therapy (evidence based)
Tailored Information and Services
Feedback
Information
© 2015 E Patient RSD GmbH, Berlin
27
Merci vielmals
Dr. Alexander Schachinger
Geschäftsführer, EPatient RSD GmbH, Berlin
[email protected]
© 2015 E Patient RSD GmbH, Berlin
28

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