Business Modelling to advance the development and implementation of eHealth technologies
Maarten van Limburg, MSc, BEngElly Kloeze, MSc
30 November 2010, Maastricht
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MAARTEN VAN LIMBURG, MSC, BENG
Background in Business IT and Innovation Management
MSc project: Business model for a Dutch PHR service
PhD Student: “eHealth Business Modelling” Eursafety Health-net project
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IN THIS TALK
Why the implementation requires attention Explanation on business models and business modelling Why business modelling in eHealth Introduction of CeHRes Roadmap
Example case: Business Modelling for a teledermatology project
Current projects and future research
More focus on how to improve eHealth technologies
User-/Human-Centered Design Involving the users of the technology Improving usability eHealth technologies reflect users needs and behaviour better Persuasive technology
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IMPROVING eHEALTH TECHNOLOGIES
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IMPLEMENTATION OF eHEALTH TECHNOLOGIES
Implementation of eHealth technologies still problematic: eHealth technologies don’t catch on in practice Lacking support from insurance companies, health professionals, etc No self-sustaining revenue model Fragmented – difficult to scale up Too technology-driven
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STAKEHOLDERS
There are a lot more parties involved than just users For the implementation the stakeholders are relevant
- health insurance companies- healthcare organizations- healthcare professionals- government- ...
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STAKEHOLDERS
Stakeholders aren’t neccesarily users of the technology “Anyone who affects or gets affected by the technology” (Freeman)
Stakeholder types: policymakers, vendors, insurers, healthcare organizations and providers, home care, employers and patients (Cain)
Every eHealth technology will have its own, specific stakeholder network(sometimes also refered to as ecosystem)
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STAKEHOLDERS EXPECT VALUE
Stakeholders expect certain benefits in return for participating in the eHealth technology. “one good turn deserves another” (Proverb) Something valuable
How can we make the implementation value-driven?
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BUSINESS MODELS
“a business model is the rationale of how an organization creates, delivers and captures value” (Osterwalder)
Used in strategic management to assess innovations Basis for implementing an eHealth technology: Assessing the implementation a priori Guideline for operationalizing the technology in practice
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COMPOSING A BUSINESS MODEL: CANVAS
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BUSINESS MODELLING
Involving stakeholders in composing the business model, they need to accept the implementation after all. Discovering what value they want Consensus, finding a fit (HOT-fit) Co-creation Continuous process
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SO WHY BUSINESS MODELLING IN EHEALTH?
As said, it can help the implementation: Sustainability Cost-effectiveness
Holistic approach Value-driven Co-creation and collaboration Flexible and reflective
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DEVELOPING IS IMPLEMENTING
Makes the whole development process value-driven If stakeholders find something valuable, make it, implement it And if they don’t, don’t!
Implementation influences development Development influences implementation
The environment determines, not only one party (outside-in)
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DEALING WITH MULTIDISCIPLINARITY
eHealth is multidisciplinary (Pagliari) Brings different types of stakeholders together Diverse values “Value” can act as a common ground: # of patients $$$ Quality
Work to a consensus or fit
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STAKEHOLDER NETWORK BECOMES A PLATFORM
Multidisciplinary nature means that collaboration is important
Getting the group who need to eventually collaboration together whilstimplementing If it doesn’t work now, it won’t work later either Finding the context of the problem
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OPENNESS
Collaboration requires openness Open business models (Chesbrough) Disease Management -> Organizational barriers fade
Willingness to co-create Using standards
Avoid problems from fragmentation
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FLEXIBILITY AND EVALUATION
Formative evaluation A business model grows: Discovery driven (McGrath) Evaluate assumptions
Environment is dynamic
Summative evaluation Technologies and implementations aren’t forever Still feasible/sustainable/cost-effective? Or re-design?
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CEHRES ROADMAP
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CEHRES ROADMAP - INSTRUMENTS
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BUSINESS MODELLING INSTRUMENTS
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ELLY KLOEZE, MSC
Background in Health Science & Policy
MSc project: Business model for a Teledermatology project
Researcher on business modelling for diabetic foot care and Pal4.
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EXAMPLE CASE: Teledermatology
Using CeHRes Roadmap for a teledermatology (TD) eHealth technology Tele-diagnostic device chronic wounds Automated diagnosis Wound evolvement
Problem identification
Stakeholder-mapping
Stakeholder analysis
Values
Functional requirements
Design requirements
Technical feasibility
Scenarios Infrastructure wound care
Business model
CONTEXTUAL INQUIRY
First indication stakeholders Focus group
Problem statement (step 1) General solutions (step 2) Contribution of technology (step 3)
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VALUE SPECIFICATION
Definitive stakeholders project Stakeholder interviews (n=11): Determine values A value = “something that is beneficially and desirable for a
stakeholder.” Determine attributes (how to realize values?) and requirements
(specification of attributes) Rank the values, attributes and requirements (1-5)
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ATTRIBUTES & REQUIREMENTS
Example of scored attributes and requirements
Nine overview schemes per stakeholder
Program of functional stakeholder requirements
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ATTRIBUTES & REQUIREMENTS
Example of scored attributes and requirements
Nine overview schemes per stakeholder
Program of functional stakeholder requirements
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Functional requirements
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high performance quality camera and technical system
objectifying shape, surface, depth, color, total size under leg, temperature, wound edge conditions
providing images
involve patient by technique and results
sharing a portal between health care providers
more alignment chain of care
transparency and uniformity of communication
financial support
integration with wound score sheets
store history and additional disorders patient
work on behalf of standard protocol
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DESIGN
More specific information about the characteristics of the design and format of the TD device Examples: handy, disinfection option, stand alone device etc.
Match stakeholder requirements with technical requirements
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OPERATIONALIZATION
Different scenarios: Role of the TD service provider Scenario 1: the General Practioner (GP) takes an image of the wound
and sends the image to the dermatologist Scenario 2: the home care nurse takes an image of the wound and
send the image to the GP
Interaction networks Who pays for which service? Who benefits? Who have a contract with
whom?
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WHICH SCENARIO SUITS BEST?
Validation of the interactionnetworks: Different stakeholders Brainstorm session technology
provider TD device Scenario 2 is preferable: the economics of scale wound care structure
improves: nice tool for communication
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BUSINESS MODEL FOR SCENARIO
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BUSINESS MODEL FOR SCENARIO
How technology fits inbusiness model of partner(Openness)
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SUMMATIVE EVALUATION
Can take place after the TD device is deployed
Test first prototype in clinical setting Test advanced prototype Results unknown for now Robustness roadmap Reflect on participatory development process Cost effectiveness
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CURRENT PROJECTS AND FUTURE RESEARCH
Different case settings: Eursafety Health-net Personal Assistant for life (PAL4) Diabetes Interactive Education Program (DIEP)
Refine and test roadmap, improve robustness
Added value for the development of eHealth technologies
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THANK YOU
E-mail : [email protected]: [email protected]
www : www.ehealthresearchcenter.org
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