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Connected HealthLatin American Perspective
4th March 2015
Latin-American Connected Health Part 1 – Overview
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
IntroductionConnected Health in LatAm
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Past Experiences: Sources of InformationConnected Health in LatAm
• 2004 Telehealth in The Americas – OAS, ITU, PAHO;
• 2005 ITU study on the impact of ICT in the Health Sector;
• 2005/06 IADB study of ICT investments for the Health Sector in the Hemisphere;
• 2007/15 Literature and Conferences
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Maturity
Pioneering ProjectsTelediagnoseDecision SupportContinuous Education
Pilot ProjectsDecision SupportContinuous Education
Implemented Projects and ProgramsSecond Opion
Stakeholders
Universities
Non Profit Organizations
GovernmentsNational / FederalLocal
CorporationsICT industryHealth Industry
Past Experiences: The Main Issue is SustainabilityConnected Health in LatAm
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
On-Going and/or in preparation Telemedicine and Telehealth Projects in 20 of the 34 OAS countriesNational Public AuthoritiesRegional Iniciatives & Forums
State of the Art’s Overview
Connected Health in LatAm
Latin-American Connected Health Part 2 – Chile’s Experience
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Chile Health Market Players
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Chile’s Connected Health Piloting (95-2004)Public Projects & Programs
Tele-EKGTele-DermatologyTele-RadiologyVirtual Presence (Telediagnose)
Private InitiativesPontifica Universidad CatólicaUniversidad de Chile (CHUCh)
From a historical perspective to On-going programs
Connected Health in Chile
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Chronic Disease Context
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
A Compelling Proposal for Health Insurers
“Lack of control over
chronic patients
generates 120k
avoidable
hospitalizations per
year”
0.7 1.2
5.122 4.519
2003 2010
Diabetes prevalence Hypertension prevalence
Reference cost per patient Final cost per patient
0%
10%
20%
30%
# Patients Expenditure
RUB5
Chronic ~30%
Other
Chronic diseases are critical component of Insurer’s medical losses
Expenditure is disproportionately concentrated in more complex patients
Experience shows tele-monitoring can reduce expenditures by up to 60%
Large opportunity size of chronic patients(number of patients, millions)
Source: Estimation based on the Encuesta Nacional de Salud 2010, Ministerio de Salud, Chile and ACG pilot 2012
Source: Chile Ministry of Health (Pilot Project ACG 2012), Company estimations
Source: US Department of Veterans Affairs, Care Coordination/Health Program
Source: Encuesta Nacional de Salud 2003, 2010, Ministerio de Salud, Chile
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Telemonitoring Chronic Disease’s Virtuous Circle
Expense per Patient ($)
Expense per patient
follows a tendency
with incremental
peaks at
decompensations
Telemonitoring
minimizes
decompensations
and softens disease
tendency
Year 1 Year 2 Year 3 Year 4 Year 5
Without Telemonitoring
Decompensation Peak Decompensation Peak
Expense per Patient ($)
Year 1 Year 2 Year 3 Year 4 Year 5
Potential Savings
With Telemonitoring
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Chilean Evidence Base’ Effectiveness
Data:
SSMS 2013-2014
Public Health
Chronic Disease
Telemonitoring
Program
Source: Adapted from Stratton IM, et al. BMJ. 2000;321:405–412
Literature shows strong evidence of disease risk reduction associated with metabolic control …
… Our results have proven a significant reduction of the ‘Disease Indicator’
0% 10% 20% 30% 40% 50%
Microvascular Disease
Periferic Vascular Disease
Myocardial Infarction
CVA
Heart Failure
Cataract Extraction
Diabetes-Related Death
� The economic impact of a reduction in the Disease Indicator can be inferred from the results of a study conducted over 4.000 patients, published in the British Medical Journal (BMJ)
• 1% decrease in Disease Indicator levels reduces disease risk in:
Note: Patients with medium-high complexity (CRS El Pino) and patients with low-medium complexity (CESFAM Joan Alsina)
CRS El Pino CESFAM Joan Alsina
Before Telemonitoring After Telemonitoring
� Clinical results shown significant reductions on patients’ “Disease
Indicator” (i.e. glycosylated hemoglobin)
10,4%
8,6%
10,3%
8,8%
-1,8 -1,5
Avenida Vitacura 2808 Piso 5, Las Condes, SantiagoTel/Fax +56 2 2369 2300 · [email protected] - www.accuhealth.cl
Business models Follow a 4 Win vision
Pricing Models: Results +++ with Savings Share with the Private Sector
Business ModelAccuHealth’s
business model
breaks the “Zero
Sum” paradigm
that negatively
affects the Health
Industry
Medical doctors
Insurers(Isapres and Fonasa)
Service Providers (Hospitals and Clinics)
Patients� Life quality improvements� Better access to medical care� Greater efficiency� Humanized environment
� Control medical loss ratios� Improve service offer� Better control of patient’s
health� Greater customer
satisfaction� Greater outreach
to patients� Greater monitor frequency� Improve patient’s support
perception� Reduce unnecessary hospitalizations
� Increase hospitalization bed turnover
� Focus on higher complexity care� Optimize resources allocation
and empowers talent
