Whats Really Going On? or PHRs, Platforms, & Consumer
Trends By: John Moore, Managing Director [email protected]
1/12/09 1 Copyright: Chilmark Research For internal use only, not
for distribution
Three Take-Aways What is State of PHR Market Today Advent of
Health Clouds Implications Trajectory Drivers Challenges What to
Watch 1/12/09 2 Copyright: Chilmark Research For internal use only,
not for distribution
While Consumers Increasingly Go Online for Health Info Source:
Pew Research 2006 74% of all adults are online 1/12/09 3 Copyright:
Chilmark Research For internal use only, not for distribution
Few Manage Their Health Records That Way Source: Forrester
Research Q208 Survey n= 5,242 Today, Meager 3.3% iManage PHI
1/12/09 4 Copyright: Chilmark Research For internal use only, not
for distribution
iPHR Adoption is Widely Dispersed Entity Type No. of PHR
Features Users Platform Kaiser- Provider 2.5M MyChart EMR portal
w/email & transaction services Permanente Portability
w/HealthVault Veterans Admin Provider 650K RYO (VistA) EMR portal,
Not portable WebMD ISV 500K WebMD Client defined, claims-based HRA
& alerts Rarely portable Aetna Payer ~250K ActiveHealth Focus
on HRA, DM, aggressive build-out Portability w/HealthVault United
Health Grp Payer ~200K HealthAtoZ Claims-based, part of new
OptumHealth Div. Portability w/HealthVault Cleveland Clinic
Provider 100K MyChart Similar to KP Portability w/Google BIDMC
Provider 40K RYO Aging portal w/email Portability w/Google &
HealthVault All Others Mix 3M Countless Highly variable, most 5
simple 1/12/09 Copyright: Chilmark Research templates Little
portability For internal use only, not for distribution
iPHR Market has Moved to B2B Model High Barriers to Entry in
Provider Market Entrenched EMR Employer & Health Plan Markets
Similar Consumer Plays Often Legacy Not actively supported B2C is
Road to Ruin for PHR Vendors 1/12/09 6 Copyright: Chilmark Research
For internal use only, not for distribution
Stand-Alone, Consumer PHI Apps: Manage Health nt e nt Co
Attributes Rating Notes Data Source NA Self-entry, Fax, Cumbersome,
Current/Trusted? Control High Owned & managed by consumer
Interoperability Medium Standards adoption increasing (CCR
dominant) Portability Medium Highly variable across vendors Tools
Modest Highly variable across vendors Personalization Low Generic,
simplistic solutions dominate 1/12/09 7 Copyright: Chilmark
Research For internal use only, not for distribution Adoption Low
Self-entry key detriment, Highly motivated only
Employer & Health Plan Sponsored Platforms: Manage Risks,
Lower Costs a nt at te sD n Co m lai C s ol A HR To Attributes
Rating Notes Data Source(s) NA Claims, PBM & HRA, Partial View
Control Low Sponsor controlled Interoperability Medium Potential
there, more talk than action Portability Low Tethered to employer
or insurer Tools Good Significant activity, behavioral change
Personalization High Copyright: Chilmark Research claims Leverage
HRA & data 1/12/09 8 For internal use only, not for
distribution Adoption Medium Trust, Incentives often required
Provider Sponsored Platforms: Consumer Retention nt e ta nt a
Co lD ca i lin C Attributes Rating Notes Data Source(s) NA EMR,
Gold Standard, Myopic Control Low Portal to host EMR
Interoperability Low Disparate systems, competitive pressures
Portability Low Tethered to EMR Tools Medium Communication for
engagement/retention Personalization Low-Med.Copyright: Chilmark
poor job, some exceptions Most do Research 1/12/09 9 For internal
use only, not for distribution Adoption Variable Perceived
value?
Utility Service Model for PHI: Creating an Ecosystem ns s ce io
ur at So ic pl ta Ap Da Secure Repository Attributes Potential
Notes Data Source(s) NA Virtually any pertinent data source Control
High Strong consumer control of data Interoperability High Adoption
of Open Systems and standards Portability Medium Still under
development Tools Very Good Multiple tools/widgets,
communications??? Personalization High Copyright: Chilmark Research
the Farther down road 1/12/09 10 For internal use only, not for
distribution Adoption High Perceived value?
Utility Service Model for PHI: A Health Cloud Ecosystem ns s ce
io ur at So ic pl ta Ap Da Secure Repository Attributes Potential
Notes Data Source(s) NA Virtually any pertinent data source Control
High Strong consumer control of data Interoperability High Adoption
of Open Systems and standards Portability Medium Still under
development Tools Very Good Multiple tools/widgets,
communications??? Personalization High Copyright: Chilmark Research
the Farther down road 1/12/09 11 For internal use only, not for
distribution Adoption High Perceived value?
Personal Health Platforms (PHP): Model & Attributes
Business Model (+) (-) PHP Dossia Lg. Employer Sponsors
Instantaneous user base of Poor partner strategy = over 8M+
employees ecosystem non-existent Initial joiners fee (founding
mbrs, $1.5M ea.) Built on open, Indivo Health Lack of traction,
slow uptake platform by employers Annual fee based on number of
subscribing Future biometrics, via Continua Portability of records?
employees Free to employees Google Attract more visitors to Clean,
easy to use interface Limited to structured data Google properties
Good consumer controlled Limited to CCR standard Health Ubiquitous
in all aspects of process for data collection Small internal
development consumers life Reasonable ecosystem grp (commitment) to
build out Have not ruled out ads in platform Future biometrics, via
Continua future TBD - ability to attract Free to consumer consumers
Microsoft Similar to Googles Largest & most complete
Cumbersome, messy ecosystem (>14,000 SDK interface Become base
for MSN HealthVault downloads) Health Mish-mash of partner apps
Largest investment of Extend desktop OS to Ulterior motives? (no
resources health e.g., Connection support for Apple OS) Center
Unique biometric capabilities TBD - ability to attract Advertising
revenue via Free to consumer consumers health search 1/12/09 12
Copyright: Chilmark Research For internal use only, not for
distribution
Dossias Ecosystem: Where is It? Date Sources 3rd Party
Apps/Services Only WebMD Live Today 1/12/09 13 Copyright: Chilmark
Research For internal use only, not for distribution
Googles Ecosystem: Stalled Date Sources 3rd Party Apps/Services
Slow Progress Recruiting Data Sources 1/12/09 14 Copyright:
Chilmark Research For internal use only, not for distribution
HealthVaults Ecosystem: Expanding Date Sources 3rd Party Apps/
Services Excellent Partner Recruitment 1/12/09 15 Copyright:
Chilmark Research For internal use only, not for distribution
Engaging the Consumer: Google Health vs MS-HealthVault Consumer
Consumer ISV1 ISV3 ISV5 ISV2 ISV4 ISV1 ISV3 ISV5 ISV2 ISV4 Models
will Significantly Affect Adoption 1/12/09 16 Copyright: Chilmark
Research For internal use only, not for distribution
Listening-In: Early Reports on PHPs Few Click-thrus from
HealthVault But good enterprise visibility Connection Center
gaining traction Over 20K users of AHA widget for BP monitoring
Highly structured, significant resources, political Grumblings:
Wheres the marketing? Significant Traffic from Google ~4k/day seen
by partner ISV Loosely structured, few resources Are they serious
about healthcare? Dossia Remains an Enigma Slow roll-out, only one
ISV live, APIs to build ecosystem? No new members/employers Wheres
the value? 1/12/09 17 Copyright: Chilmark Research For internal use
only, not for distribution
Looking to the Future for PHPs HealthVault No Longer Standalone
Property Embedded in MSNHealth Maintains strong clinical
underpinnings Google Focuses on Wellness Healthy consumer centric
Turns to ad-rev model for support Ads outside private domain Dossia
Slowly Fades New members slow to appear Governance challenges Not
an influencer in the market Fourth Entity Appears Many circling
today 1/12/09 18 Copyright: Chilmark Research For internal use
only, not for distribution
Is the iPhone a Platform? Leading Mobile Web Platform 46% NA
mkt share 32% WW mkt share Tremendous Momentum Over 10K Apps Over
450 in Health & Wellness Technically, Not a Cloud Platform but
Becoming de facto platform 1/12/09 19 Copyright: Chilmark Research
For internal use only, not for distribution
Evolution Accelerates PHR Adoption Adoption High User Value
Proposition Gen 4: Personal, Users Actionable, & (Millions)
Connected 80 Gen 3: Data Aggregation (Health Clouds Form) Gen 2:
Online 40 20 Gen 1: Isolated Low Time 2000 2003 1992 2008 2011
(Online) 1/12/09 20 Copyright: Chilmark Research For internal use
only, not for distribution
Generation 4: Convergence Personal, Actionable, Connected
Value: About Me, By Me, With Me, For Me, Because of Me 1/12/09 21
Copyright: Chilmark Research For internal use only, not for
distribution
Moving Ahead: Adoption Challenges Remain Data Liquidity EMR
adoption Standards Adoption Policies & Incentives Portability,
Privacy, Liability Trust Health Plan, Employer, 3rd Party Consumer
Apathy/Indifference Education Incentives Solution Capabilities
Immature, Disparate 1/12/09 22 Copyright: Chilmark Research For
internal use only, not for distribution
Drivers to Overcome Challenges Accelerating, Employer-led
Initiatives Employees Financial Skin Accelerating IT Adoption Among
Providers Incentives, e.g., eVisits, eRx Consumerism Entering
Healthcare Visibility, Education New Consumer-centric Technologies
& Tools Delivering Radically New Capabilities Disintermediation
of Care Retail Clinics, Med Tourism, etc. Providers Becoming
Consumer-Savvy 1/12/09 23 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 Which
sub-groups adopt Developer Adoption What are popular apps/services
Market Consolidation Rationalization & Acquisitions New players
entering Employer Successes Demonstrable ROI All Things mHealth
Smartphones App Ecosystems Biometrics + Smartphone 1/12/09 24
Copyright: Chilmark Research For internal use only, not for
distribution
Final Thoughts Privacy is a Ruse Value is the Metric Most PHRs
are Garbage Time to Kill PHR Term Dated, confusing, and not
reflective of consumer needs Govt. Sponsored RHIOs & NHIN are
Folly Self-forming Clouds rain on parade HIT Stimulus may be Wet
Cement Difficult to chip-out later 1/12/09 25 Copyright: Chilmark
Research For internal use only, not for distribution
www.ChilmarkResearch.com 5 JFK St., Suite 404 Cambridge, MA
02138 1/12/09 26 Copyright: Chilmark Research For internal use
only, not for distribution