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June 13, 2008 Copyright : Chilmark Research For internal use only, not for distribution Evolving PHR Market Analysis & Trends Presented for HHS, AHIC Consumer Empowerment Workgroup June 17, 2008 By: John Moore, Managing Director Chilmark Research [email protected]

PHR Market 2008: Analysis & Trends

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Page 1: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Evolving PHR Market

Analysis & TrendsPresented for HHS, AHIC Consumer Empowerment Workgroup

June 17, 2008

By: John Moore, Managing Director

Chilmark Research

[email protected]

Page 2: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Three Take-Aways

What is MarketStructure Today

How will MarketEvolve

4 Generations

Trajectory

Drivers

Challenges

What to Watch

Page 3: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

PHR Market has Re-ignited

Page 4: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Who is Engaging a PHR

Total Adoption Today:~5-7%

Consumer Profile:

Mid to Upper Class

Middle Aged

Working Mothers withMedical Proxy

Chronic Care & Web-savvy

Little Adoption AmongHealthy

Source: Intuit Survey 2005

Financial “Skin in the Game” will Play a Large Role

Page 5: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Market has Moved to B2B Model

High Barriers to Entry in Provider Market

Employer & Health Plan Markets Similar

Consumer Plays are Often Legacy

Primary Market Secondary Market

Page 6: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

PHR Sponsors

Not comprehensive

Not interactive

Most are tethered

Clinical & lab data

Online consultations,

scheduling, Rx refill

Trust

Customer retention

Workflow

Lower Readmissions

Provider

Trust

Claims data not clinical

Most are tethered

Claims & meds

HRA & PBM

Domain expertise

Provider info

Lower medical losses

Behavioral change

Differentiator - CDHP

Health

Plan

Trust

Incentives required

Most are tethered

Health & wellness

Integrated to HR

package

Can be comprehensive

Lower HC costs

Increase productivity

Support CDHP

Employer

Disconnected - self

entry

Low adoption

Privacy & security

(-)

Motivated

Personal control

Portable

Chronic disease

mgmt

Care mgmt

CDHP mgmt

Consumer

(+)Motivation(s)Sponsor

Page 7: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

PHR Market is Highly Fragmented

Extremely Difficult to Choose Viable Solution

*

*iPHRs: Internet-based PHR

Page 8: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Content

1st Generation: Isolated

Value: Track & Manage Care

Target: End Consumer

Most 3rd Party PHRs

Stuck Here

85% of those

interviewed

Adoption Remains Low

Generic

Little personalization

Self-entry

Only for VERYmotivated

Page 9: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Content

Value: Facilitate Interaction, Promote Healthy Behavior

2nd Generation: Online with Some Data

Claim

s or

Clinic

al Data

Target: Businesses

Insurers, Employers,Providers

Land Rush by Insurers &Employers

Manage/Lower RisksHRAs, Behaviors, CDHP

Provider MarketDominated by EMR Vendors

Customer RetentionCommunication

Adoption Highly Variable

Trust, Perceived ValueIncentives often req’d

Some self-entry required

Portability?

Page 10: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

3rd Generation: Highly Networked Utility

Value: Richer Data = Richer Experience

Target: Consumers

Exception - Dossia

Three Dominant Players

Dossia, Google, HealthVault

Utility Service Model

Perform Heavy LiftingData Repository

Multiple sources

Identification Mgmt

Security/Privacy

Market Contraction

Accelerate Demise of Weak

Adoption Unknown

Can They Get the Data?

Can They Build an Ecosystem?

Trust, Value

Not a PHR, but a Platform:

Personal Health System (PHS)

Data

Data

App

s

Dev

ices

Page 11: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Dossia’s Utility Model

Dossia Data Services

Dossia Data Framework

Dossia Open API

EMR

ProviderMeds Claims Labs Images

Dossia Data Provider Network

Dossia Ecosystem

Dossia SIG

Dossia.Org

Built on INDIVOHEALTH

PHA

PHA

PHA PHA

PHA

Dossia Certification Prog.

Dossia Logo Prog.

Google Health & HealthVault have Similar Models

Page 12: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Successful (PHSs) Will Evolve IntoEcosystems

If Successful…

Data ConsolidationData liquidity

Unmatched

Richness

Game Changing

Consumer

Empowering

Providers

PHAs

(PHRs)Researchers

Insurers

PHS(e.g., Dossia)

Devices

Page 13: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

4th Generation: Personal, Actionable, Connected

Value: About Me, By Me, With Me, For Me

Target: All Markets

Leverage Utility Services

Now that we have the data…

Market Fragmentation

Proliferation of Apps & WidgetsServe highly individual needs

Enable personalized medicine

Seamless Integration

“SPIME”Always on

Adoption Predicated On…

Liquid Data

Success of ecosystems

Consumer Value

Page 14: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

PHR Evolution Accelerates Adoption

2008

Gen 3: Data Aggregation

(Rise of PHS)

Gen 4: Personal,

Actionable, &

Connected

Gen 2: Online

2011

Gen 1: Isolated

20031992 Time

Value

Adoption

2000

(Online)

20

1992

40

80

Users

(Millions)

Page 15: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Moving Ahead:

Adoption Challenges Remain

Data Liquidity

EMR adoption

Standards Adoption

Policies & Incentives

Portability

Trust

Health Plan, Employer, 3rd Party

Consumer Apathy/Indifference

Education

Incentives

Solution Capabilities

Immature, Disparate

Page 16: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

Drivers to Overcome Challenges

Accelerating, Employer-led Initiatives

Financial Skin

Consumerism Entering Healthcare

Visibility, Education

Accelerating IT Adoption

Among Providers

E-Consultations

New Consumer-centric

Technologies & Tools

Delivering Radically New Capabilities

Disintermediation of Care

Retail Clinics, Med Tourism, etc.

Will Consumer Drive Needed Change?

Page 17: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

What to Watch

Traction of Platform Plays

Data Sources (agreements)

E.g., Cleveland-Google, KP-MS

Consumer Adoption

Sub-group types

Developer Adoption

Popular apps/services

Market Consolidation

Rationalization

Acquisitions

Employer Successes

Demonstrable ROI

Page 18: PHR Market 2008: Analysis & Trends

June 13, 2008 Copyright: Chilmark Research

For internal use only, not for distribution

The world is moving so fast thesedays that the one who says it can’tbe done is generally interrupted bysomeone doing it.

- Harry Emerson Fosdick