Upload
others
View
1
Download
0
Embed Size (px)
Citation preview
1
Business Modelling Panel
Lisette van Gemert-Pijnen (mod)
Maarten van Limburg
February 12, 2010
eTELEMED 2010, St Maarten
PANEL Digital Society Trends:Business modelling for design & implementation of HealthcareTechnology
Lisette van Gemert-Pijnen
University of Twente The Netherlands
Maarten van Limburg University of Twente The Netherlands
Liezl van Dyk Stellenbosch University South Africa
Marike Hettinga Windesheim The Netherlands
LambertNieuwenhuisHans C. Ossebaard
University of TwenteNational Institute forPublic Health and theEnvironment
The NetherlandsThe Netherlands
Panel procedures
Self-Introduction of panelists
Short propositions
Discussion-statements
Response from the audience
Response from the panel
Interaction between/among panel andaudience
Business models and eHealth (Maarten)
A Business model is ‘the rationale of how anorganization creates, delivers and capturesvalue’.
Going from ‘traditional healthcare services’ toeHealth services requires health organizations toreinvent themselves.
Business modelling facilitates that step!
19-3-2010Presentatie 4
A business model
19-3-2010Presentatie 5
Infrastructure CustomerValueProposition
Finances
Valueproposition
Customerrelationship
Distributionchannels
Targetcustomers
Partnernetwork
Valueconfiguration
Corecapabilities
Coststructure
Revenuemodel
Osterwalder, Pigneur (2004)
Business modelling is a collaborative process withclients as most relevant stakes (Lisette)
Different from business casus, models
Different from cost benefit analysis
Multi-perspective focus
Service (intangible) oriented
Clients as drivers
Co-creation of values
Consensus-driven
Formative evaluation
Examples business models other industries
3 successful, different business models:
Philips Senseo (co-creation)
Ryan Air (collaboration of stakeholders)
Apple (user-centered innovation)
And in eHealth ???
Statement #1 (Maarten)
The process of business modelling is just asimportant as the business model itself.
High # of stakeholders
Conflicting interests
Complex money flows
19-3-2010Presentatie 8
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 9
Process is equally important as the numbers (Bart)
actor types─ insurance company
─ general practitioner
─ pharmacist
─ home care
─ physiotherapist
─ nursing houses
─ mental health care
─ hospital – specialists
─ hospital – logistics
─ insurer
─ network provider
─ clearing house
aspects─ prevention, diagnostics, therapy, quality, medication,
medical aid, personnel, reimbursement, payment
businessprocesses
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 10
Process to analyze impact of a new service
more/less work
more/less failures
more/less quality
…
…
actor
effectactoreffect
process
processeffect
process effectowner
processvolume
process effectvalue
actor effectvalue
period
Statement # 2 Upside down approach (Bart)
approach is important!
Business modelling in an early design phase
Calculation on costs in an early phase, upsidedown approach
Upsidedown
Early stage in a project
Stakeholders participate from start
Formative evaluation of alternative role divisions
(switch presentation)
Statement # 3 Emphasize organisational design(Marike)
Aap
not
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 13
Statement # 4 “it’s about economy, stupid” (Bart)
Costs health Care 1998 - 2005
€ 0 M
€ 5.000 M
€ 10.000 M
€ 15.000 M
€ 20.000 M
€ 25.000 M
€ 30.000 M
€ 35.000 M
€ 40.000 M
€ 45.000 M
1998 1999 2000 2001 2002 2003 2004 2005*
Verstrekkers ondersteunende diensten
Verstr. geestelijke gezondheidszorg
Tandartsenpraktijken
Specialistenpraktijken
Paramedische-/verloskundigenpraktijken
Overige verstrekkers gezondheidszorg
Leveranciers therapeutische midd.
Leveranciers geneesmiddelen
Huisartsenpraktijken
Gemeentelijke gezondheidsdiensten
Categorale ziekenhuizen
ARBO-diensten
Algemene ziekenhuizen
Academische ziekenhuizen
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 14
Size of population in nl in 2007
Source: Centraal Bureau voor de Statistiek, Voorburg/Heerlen 2007
Size of population in The Netherlands in 2007
K
50 K
100 K
150 K
200 K
250 K
300 K
0 10 20 30 40 50 60 70 80 90
Age
Nu
mb
er
2007
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 15
Size of population in nl in 2007 and 2020
Source: Centraal Bureau voor de Statistiek, Voorburg/Heerlen 2007
Size of population in The Netherlands in 2007 and 2020
K
50 K
100 K
150 K
200 K
250 K
300 K
0 10 20 30 40 50 60 70 80 90
Age
Nu
mb
er
2007 2020
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 16
Illness related costs/capita in nl - 2003
0
10.000
20.000
30.000
40.000
50.000
60.000
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95+
Niet toew ijsbaar / Niet ziekte gerelateerd
Ongevalsletsel en vergif tigingen
Onvelledig omschreven
Aandoeningen perinatale periode
Congenitale afw ijkingen
Bew egingsstelsel en bindw eefsel
Huid en subcutis
Zw angerschap, bevalling en kraambed
Urogenitaal systeem
Spijsverteringsstelsel
Ademhalingsw egen
Hartvaatstelsel
Zenuw stelsel en zintuigen
Psychische stoornissen
Bloed en bloedvormende organen
Endocriene, voedings en stofw . ziekten
Nieuw vormingen
Infectieziekten en parasitaire ziekten
Copyright RIVM, 2006. Slobbe LCJ, Kommer GJ, Smit JM, Groen J, Meerding WJ,Polder JJ. Kosten van Ziekten in Nederland 2003 (www.kostenvanziekten.nl)
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 17
Health costs during the last years of life
€ -
€ 5.000
€ 10.000
€ 15.000
€ 20.000
€ 25.000
€ 30.000
€ 35.000
€ 40.000
€ 45.000
€ 50.000
9-14 15-24 25-44 45-64 65-74 75-84 85+
x
x - 1
x - 2
x - 3
x - 4
x - 5
x - 6
x - 7
x - 8
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 18
PUBLIC AND MARKET SERVICESLabor productivity developments
Publieke prestaties in perspectief, SCP, Jan 2007, page 46
cost reduction due to re-use of medicalinformation
cost reduction due to decrease of medicationerrors
reduction of costs required for additional healthcare
cost reduction due to improved labour productivity
increased cost/benefit ratio due to increasedquality
Feb 12, 2010Bart Nieuwenhuis - School of Management and Governance 19
Well-known effects of ict in health care
Statement #5 Patients complicate business modelling(Maarten en Marike)
Patients have a delicate role in healthcare
Patients are no real customers
Patients are not the deciding or payingstakeholder
Asymmetric relationships, heavily dependanton trust
‘What do patients want’ vs. ‘We know what’sbest’
19-3-2010Presentatie 20
Statement #6 Business modelling implies a holisticapproach (Maarten, Hans)
Collaborating health organizations
Collaborating with patients
Empowering patients
Iterative process stimulating reconsideration ofdeep-rooted assumptions
19-3-2010Presentatie 21
•Telemedicine is a multidisciplinary effort
(Switch presentation)
Statement # 7 Cooperation a multidisciplinary effort,but… (Liezl)
Statement #8 Business modeling is overlookedor poorly understood in health care (Maarten)
Existing business models are “simple sums”-models
Based on fuzzy assumptions
Skewed Critical Design Issues
Borrowed Business models
19-3-2010Presentatie 25
Thank youMerci beaucoup
Baaie dankieBedankt
Why to use Business Modeling forDesign and Implementation ofHealthcare Technology
Telemedicine:
A multidisciplinary effort
Liezl van Dyk(Stellenbosch University)•“Bedryfsingenieur”
•Operations Research (MathematicalModeling for Decision Making)•Systems/ Business/ EnterprizeEngineering
•2005-2008 – E-learning Advisor
•From 2009: Engineering Management
•Engineering Faculty Telemedicineproject
S
Business (Process) Modeling ≠ Business Model
Managementbusinessprocesses
Operationalprocesses
Supportingprocesses
Telemedicine:
A multidisciplinary effort
Technology push Needs pull
Bottom-up
Top-down
Telemedicine:
A multidisciplinary effort
Regional Systems of Innovation
External Influences
Knowledge generation and diffusion subsystemKnowledge generation and diffusion subsystem
Knowledge application and exploitation subsystem
Customer
Collaborators
Contractors
Competitors
IndustrialCompaniesIndustrial
Companies
Workforce mediatingorganizations
Workforce mediatingorganizations
EducationalorganizationsEducational
organizations
Technology mediatingorganizations
Technology mediatingorganizations
Public researchorganizations
Public researchorganizations
Knowledge, resource andcapital flows and interactions
Regional socio-economic and cultural setting
• Individual patient? Family of individual patient?• Doctor? / Nurse? / Doctor-in-training• Hospital (hospital group)? / Pharmacy? / Drug developer?• Government (public health)? Private Healthcare provider?• Medical School? / Medical Student? / Government?
Who isthe
customer?
Who isthe
customer?
Open Business Models as answer toeTELEMED initiatives?
Telemedicine:
A multidisciplinary effort
“How to” Open Innovation
Telemedicine:
A multidisciplinary effort
• Is Open Innovation and Open Business Modelsthe answer to getting things work in a multi-disciplinary environment?
• Is Web 2.0 an answer to the need for KnowledgeNetworks within context of eTELEMED?
Telemedicine:
A multidisciplinary effort
Organisational design asrequirement for sustainableembedding of telemedicine
Panel contribution e-Telemed, February 12, 2010
Marike Hettinga, Timber Haaker, Sikke VisserWindesheim University of Applied Sciences, Zwolle, the Netherlands
& Novay, Enschede, the Netherlands
gap between project and practice is too deep:• too often: end-of-project equals end-of-telemed-innovation
• too late during project: anticipation on sustainable embedding ofinnovation in regular care practice
opportunity using business model method:• perspective switch: telemed-innovation as a service instead of a
solely technological innovation
• development of a viable business model for this service
Viable Telemedicine!
Business model
Servicese.g., Value proposition,Target group
Organisationse.g., Division roles,Network strategy
Technologye.g., Service deliverysystem
Financiale.g., Revenue model
Value forcustomers
Value forproviders
Creating successful ICT-services, practical guidelines based on the STOF method, Edward Faber en Henny de Vos (2008)See also: www.stofmethod.com
An example:
Organizational arrangements for aPersonalized Dementia Directory
(PDD)
in an early stage of the project:
- draw an inventory of all activitiesneeded to offer this service
- cluster these activities in roles
Advertisers Sponsors
UsersPDD-service
provider
Care or wellfareservice providers
Informationservice providers
General role modelfor PDD
Alternative organizationalarrangements
Commercialmodel
Govermentmodel
Insurermodel
Patientcommunity
model
Care providermodel
discuss alternative models withstakeholders
graphical presentation makes it concreteand serves as a vehicle for discussion
Think of your own telemedicineprojects…
How and when did you anticipate on theorganizational role division for thesustainable offering of the service?
Please share your best practices!