Global Healthcare Trends

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1、Business Consulting Services Copyright IBM Corporation 2002Global Healthcare TrendsPresentation to IBM Public Sector Leadership ForumFriday, February 7, 2003Presenter: Neil Stuart, IBM BCS CanadaBusiness Consulting Services Copyright IBM Corporation 20022Overview of PresentationPurpose of presentati

2、on: to provoke thinking about the future needs of our clients/customers and opportunities for IBM The big trends Some potential surprises Implications for our customers/clients Developments in the market Opportunities for IBMBusiness Consulting Services Copyright IBM Corporation 20023Thought Leaders

3、hip Lots Done, More to Come Futures analysis -PricewaterhouseCoopers HealthCast 2010, and HealthCast Tactics-E-Health Transformation PWC Europe-IBMs Healthcare 2012 More in the works-Multi-client study on payor operations/performance in U.S.-Canadian POV Health on demandBusiness Consulting Services

4、Copyright IBM Corporation 20024The Big Trends More demanding, better informed consumers Genomics E-world Demographic change Financial sustainability of healthcare coverage Human resources concerns Evidence based-practice Patient safetyBusiness Consulting Services Copyright IBM Corporation 20025Consu

5、mers will be a Continuing Story Consumers are and will be transformed by-New attitudes demanding and aging boomers, paying for a bigger part of their care-New expectations a voice, choice, personalized care, partnerships with providers-New tools report cards, patient charters, personal electronic he

6、alth records-The Internet - information, new knowledge, much greater health literacy and new models of accessing services-Genetic foresight knowledge of their own genetic futures Demand driven healthcare Consumer-inclusive solutions Health organizations that do not get it will fall behindBusiness Co

7、nsulting Services Copyright IBM Corporation 20026Genomics, a Sleeping Giant Accessible genetic testing-Individual awareness of our genetic futures-Longer disease life cycles and greater demand/costs-Demand for new kinds of preemptive services Gene specific, designer drugs-Much more effective drug th

8、erapy-Huge cost escalation Consumers anxious about their genetic futures Greatly increased clinical precision and clinical complexity Much greater density of clinical information Costs pressuresBusiness Consulting Services Copyright IBM Corporation 20027E-world - Larger Markets, Extended reach for H

9、ealthcare E-delivery of services-Remote diagnostics, specialist consultations, even remote surgery!-Remote monitoring of chronic conditions-Teletriage-E-mail primary care consults-Information, appointments, test results, prescriptions, referrals Electronic health records E-markets and e-purchasing I

10、ncreasing the reach of providers Globalization and blurring of old health jurisdictions Patient access to EHRs giving consumers one more lever to increase control Scale challenges for suppliersBusiness Consulting Services Copyright IBM Corporation 20028The Sustainability Question Multiple pressures

11、on the the cost and affordability of healthcare-Demanding consumers-Demographics aging population-Expensive drugs that work even better-Costs of new technologies - IT, Dx, Rx-Costs of updating old infrastructure/facilities Healthcare consuming ever larger part of government spend the healthcare mons

12、ter Opportunities for new players and the private sector Increasing health inequities Focusing resources on interventions that produce outcomes Pressures in the U.S. for a national health planBusiness Consulting Services Copyright IBM Corporation 20029The “Healthcare Monster” a headache for governme

13、nts and payors that will not go away“The rising cost of healthcare has brought on a fiscal crisis in many (U.S.) states. Their combined budget deficit is estimated to worsen to $60 - $85B in 2004, which is equivalent to 13 18% of their total expenditure.”- Kaiser Family Foundation, January 2003Busin

14、ess Consulting Services Copyright IBM Corporation 200210Potential Surprises Prolonged war in the Middle East leading to an economic downturn-Taking money from health budgets, particularly capital budgets Massive bio-terrorism offensive against major Western cities-Diversion of health resources Globa

15、lization of infectious disease continues West Nile, Mad Cow, etc.-Global health surveillance and collaboration Increasing numbers/prevalence of drug resistant disease strains-Return of long inpatient stays, isolation care Sooner than expected breakthroughs on gene therapy-New ball game Surprises alw

16、ays reveal new needs/gaps (think of HIV, anthrax) Look ahead, spot the customer need, respond smartly and quicklyBusiness Consulting Services Copyright IBM Corporation 200211Four BIG PICTURE business directions for our customers/clients1.Managing demand for services2.Measuring, managing and paying f

17、or performance3.Providing ready access to health information4.Making health care organizations employers of choiceBusiness Consulting Services Copyright IBM Corporation 2002121. Managing demand for services Consumerism is changing the way clinical/service decisions are made decisions no longer just

18、with providers Concerns about sustainability and overwhelming growth in demand Strategies to manage demand and channel consumerism-Partnerships with patients/users-Matching providers and patients and team based care-Informing and educating patients-Tools for self-monitoring, self-care, self-service-

19、Devices that offer/require choice, e.g. defined contribution plans, MSAs-Taking advantage of of opportunities for e-service-Disease management focusing on chronic diseases (cancer, diabetes, asthma, cardiac, etc)Business Consulting Services Copyright IBM Corporation 200213FUTURETODAYFor U.S. health

20、plans, the need to address costs and consumer demands will fundamentally alter their role Employer-driven Insulated consumer Defined benefit/limited choices No decision making tools Full service health plans Antiquated business infrastructure Member-driven, with member more financially accountable M

21、ovement toward defined contribution Emergence of assisted decision making More specialized health plan focus Flexible technology infrastructure Emergence of non-traditional competitorsBanks/ Financial InstitutionsHealth Advisor/BrokerEmployee$TPANetworkCare MgmtOtherInsuranceEmployerEmployeeHealth P

22、lan BHealth Plan CHealth Plan ABenefits Consultant/Broker$EmployerHealth BenefitPackageThe Pain TransplantBusiness Consulting Services Copyright IBM Corporation 2002141. Managing demand for services Some relevant IBM offerings-CRM-Payor systems, including outsourced services (Empire-Blue Cross-U.S.)

23、-Consumer surveys (HealthInsider-Canada)Business Consulting Services Copyright IBM Corporation 2002152. Measuring, managing and paying for performance To date there has been little financial reward for quality and service excellence Escalating costs and concerns about sustainability highlight the im

24、portance of focusing resources for maximum impact Research on preventable errors is underlining concern re patient safety Some actions that will shift more attention to performance include:-Developing and implementing patient safety and quality indicators-Measuring and rewarding for patient satisfac

25、tion-Giving quality incentives to service providers-Informing stakeholders on what works and what is excellent-Transparent resource allocation-Payor concerns with efficiencies-Paying attention to system performance tooBusiness Consulting Services Copyright IBM Corporation 2002162. Measuring, managin

26、g and paying for performance Some relevant IBM offerings-Data warehousing-Many BCS assignments on report cards (Canadian Institute for Health Information)-Program evaluation-Consumer surveys e.g. IBM HealthInsider-Addressing payor performanceBusiness Consulting Services Copyright IBM Corporation 200

27、2173. Providing ready access to information Access to health information to support the patient care process is slow and fragmented Inadequate access to information has been an impediment to evidence-based practices and linked to patient safety issues Strategies to support ready access to useful inf

28、ormation include:-Point-of-care computing -Ensuring privacy and security-Setting realistic timetables-Developing open, flexible architectures-Investing in data warehouses and performance monitoring metrics-Providing ongoing training-Patient access to and even control over their EMR-Consumer access t

29、o system/provider performance informationBusiness Consulting Services Copyright IBM Corporation 2002183. Providing ready access to information IBMs offerings-HIPAA work in U.S.-Vendor alliances e.g. Cerner-Healthcare integration e.g. Alberta we/netBusiness Consulting Services Copyright IBM Corporati

30、on 2002194. Making health care organizations employers of choice Health care organization used to be a prized place to work - - security, helping people, status New entrants to the job market are looking for other features to their work - - flexibility, team-based, learning/development opportunities

31、, state-of-the-art technology Some strategies to make health care organizations a work place of choice-Flatter organizations pushing decision making down the hierarchy-Career options/development/training-Team environments-B2E/employee portals-Flexible pay and benefits-Linking employee and patient sa

32、tisfaction-Above all, respect for employeesBusiness Consulting Services Copyright IBM Corporation 2002204. Making health care organizations employers of choice IBMs offerings-BCSs Human Capital Solutions, including Learning Solutions-Examples of assignments completed (hospitals as employers of choic

33、e, HR retention)-B2E portalsBusiness Consulting Services Copyright IBM Corporation 200221Some nearer-term market trends Consumer driven health plans Wireless/mobile solutions (mainly from established vendors) get traction Growing use of web in healthcare supply chain Convergence of electronic physic

34、ian order entry and e-procurement Outsourcing takes off offered by vendors an answer for customers lack of capital Healthcare spending on outside IT services surpassing internal IT spend Healthcare IT spend will have to a show strong business case IT will be seen more as answer for human resource sh

35、ortagesBusiness Consulting Services Copyright IBM Corporation 200222IT Opportunities for IBM* Consumerism and demand management drive CRM-CRM opportunity will grow 25% from 2003 to 2006 E-world drives SCM opportunity, e-markets and e-procurement-20% plus growth rates projected in SCM and e-markets f

36、or IBM Services are the biggest IT opportunity-Services are the largest and generally fastest growing segment of opportunity by geography and solution market* Source of projections: IBM Market Intelligence Sales & DistributionBusiness Consulting Services Copyright IBM Corporation 200223IT Opport

37、unities for IBM (more.) Mobile computing-Implementation application vendor alliances-Security issues-Hardware product to compete with Compaq/HP, Microsoft, Palm? Outsourcing-Payer systems, claims management, back office, PC/network support Privacy and security-US market being driven by HIPAA, parall

38、el interest in other jurisdictions Healthcare integration-E-business integration, portals, B2E, B2B, B2C Business on Demand, Information on Demand, Healthcare on DemandBusiness Consulting Services Copyright IBM Corporation 200224Questions and DiscussionBusiness Consulting Services Copyright IBM Corp

39、oration 200225Healthcare Solutions by Geo and Solution: CRM and ERP are Largest Opportunities$2,137$635$301$2,220$1,485CRME-marketse-ProcurementERPSCM$0$500$1,000$1,500$2,000$2,500Millions of dollarsHealthcare WW Solutions Oppty2003 - Large Enterprises (1000+)Source: 2H02 Solution Market ViewBusines

40、s Consulting Services Copyright IBM Corporation 200226Healthcare Solutions by Geo and Solution: CRM and ERP are Largest OpportunitiesAmericas$5,21777.0%EMEA$1,29919.2%AP$2623.9%Millions of dollarsHealthcare WW Total Sols Oppty by Geo2003 - Large Enterprises (1000+)Source: 2H02 Solution Market ViewBu

41、siness Consulting Services Copyright IBM Corporation 200227Total WW Healthcare Sols Opportunity 2003 (Large Enterprises) $6.8B$1,717$525$242$1,829$904CRME-marketse-ProcurementERPSCM$0$500$1,000$1,500$2,000Millions of dollarsHealthcare Americas Solutions Oppty2003 - Large Enterprises (1000+)Source: 2

42、H02 Solution Market ViewBusiness Consulting Services Copyright IBM Corporation 200228Total WW Healthcare Sols Opportunity 2003 (Large Enterprises) $6.8B$390$59$40$354$456CRME-marketse-ProcurementERPSCM$0$100$200$300$400$500Millions of dollarsHealthcare EMEA Solutions Oppty2003 - Large Enterprises (1

43、000+)Source: 2H02 Solution Market ViewBusiness Consulting Services Copyright IBM Corporation 200229Total WW Healthcare Sols Opportunity 2003 (Large Enterprises) $6.8B$30$51$19$37$125CRME-marketse-ProcurementERPSCM$0$50$100$150Millions of dollarsHealthcare AP Solutions Oppty2003 - Large Enterprises (

44、1000+)Source: 2H02 Solution Market ViewBusiness Consulting Services Copyright IBM Corporation 200230CRM Has Highest Growth Rates in Geos, While ERP Has Lowest GrowthSolutions2002$M2003$M02-03 %Change2004$M2005$M2006$M03-06 CAGR %CRM1,3691,71725.5%2,2262,7493,28024.1%e-Markets43552520.1%67077999123.6

45、%E-Procurement20324219.2%29234140018.2%ERP1,7481,8294.6%1,8411,7721,8921.1%SCM77090417.4%1,0811,2921,57220.2%Total4,5255,21715.3%6,1106,9338,13516.0%Americas Healthcare Solutions Growth Rates (Large Enterprises) Source: 2H02 SMVBusiness Consulting Services Copyright IBM Corporation 200231CRM Has Hig

46、hest Growth Rates in Geos, While ERP Has Lowest GrowthSolutions2002$M2003$M02-03 %Change2004$M2005$M2006$M03-06 CAGR %CRM34639012.7%51460073523.5%e-Markets455931.1%738610621.6%E-Procurement334021.2%46536014.5%ERP31635412.0%3423543721.7%SCM38145619.7%54065278920.1%Total1,1211,29915.9%1,5151,7452,0621

47、6.7%EMEA Healthcare Solutions Growth Rates (Large Enterprises) Source: 2H02 SMVBusiness Consulting Services Copyright IBM Corporation 200232CRM Has Highest Growth Rates in Geos, While ERP Has Lowest GrowthSolutions2002$M2003$M02-03 %Change2004$M2005$M2006$M03-06 CAGR %CRM223036.4%39496026.0%e-Market

48、s405127.5%63809723.9%E-Procurement171911.8%22283117.7%ERP313719.4%45546218.8%SCM9612530.2%15819022321.3%Total20626227.2%32740147321.8%AP Healthcare Solutions Growth Rates (Large Enterprises) Source: 2H02 SMVBusiness Consulting Services Copyright IBM Corporation 200233Services is Largest Solutions Op

49、portunity in Americas for CRM, ERP and SCMApp SW$29117.0%Bus Consult$17110.0%Clients$523.0%IT Consulting$593.4%Other Svcs$67339.3%Servers$553.2%SI$35120.5%Technology$342.0%2003 Americas CRM Oppty By P/SHealthcare - Large Enter. ($ Millions)Source: 2H02 SMVBusiness Consulting Services Copyright IBM C

50、orporation 200234Services is Largest Solutions Opportunity in Americas for CRM, ERP and SCMApp SW$13715.2%Bus Consult$829.1%Clients$60.7%IT Consulting$465.1%MW$283.1%Servers$333.7%SI$36440.5%Technology$343.8%2003 Americas SCM Oppty By P/SHealthcare - Large Enter. ($ Millions)Source: 2H02 SMVBusiness

51、 Consulting Services Copyright IBM Corporation 200235Services is Largest Solutions Opportunity in Americas for CRM, ERP and SCMApp SW$33018.1%Bus Consult$1327.2%Clients$412.2%IT Consulting$1618.8%MW$713.9%Other Svcs$66236.3%Servers$804.4%SI$31117.0%Technology$372.0%2003 Americas ERP Oppty By P/SHeal

52、thcare - Large Enter. ($ Millions)Source: 2H02 SMVBusiness Consulting Services Copyright IBM Corporation 200236Services is Largest Solutions Opportunity in Americas for CRM, ERP and SCM Services (SI, IT Consulting, Bus. Consulting, Other Services) total 73.2% of Americas CRM oppty, 69.3% of ERP oppt

53、y, and 73.5% of SCM oppty HW (Servers, Clients, Technology) is a relatively small portion of Americas solutions oppty (8.2% for CRM, 16.8% for ERP, 8.2% for SCM) CRM, ERP and SCM Apps SW are relatively small portions of total Americas solutions oppty (15.2% to 18.1%), but will drag many Services pur

54、chases SI is the largest segment of Americas SCM oppty (40.5%), more than double the percentage for CRM and ERPBusiness Consulting Services Copyright IBM Corporation 200237Services is Top Opportunity for CRM, ERP, SCM in EMEAApp SW$5113.1%Bus Consult$277.0%Clients$338.5%IT Consulting$71.8%MW$41.0%Ot

55、her Svcs$15038.7%Servers$143.6%SI$9424.2%Technology$82.1%2003 EMEA CRM Oppty By P/SHealthcare - Large Enter. ($ Millions)Source: 2H02 SMVTotal 2003 CRM oppty: $390MBusiness Consulting Services Copyright IBM Corporation 200238Services is Top Opportunity for CRM, ERP, SCM in EMEAApp SW$7421.0%Bus Cons

56、ult$329.1%Clients$216.0%IT Consulting$144.0%Other Svcs$10630.1%Servers$246.8%SI$5716.2%Technology$102.8%2003 EMEA ERP Oppty By P/SHealthcare - Large Enter. ($ Millions)Source: 2H02 SMVTotal 2003 ERP oppty: $354MBusiness Consulting Services Copyright IBM Corporation 200239Services is Top Opportunity

57、for CRM, ERP, SCM in EMEAApp SW$408.8%6.0%Clients$30.7%IT Consulting$143.1%MW$81.8%Other Svcs$10523.2%Servers$132.9%SI$23050.9%Technology$122.7%2003 EMEA SCM Oppty by P/STotal 2003 SCM oppty: $456MBusiness Consulting Services Copyright IBM Corporation 200240Services is Top Opportunity for CRM, ERP,

58、SCM in EMEA Services (Bus. Consulting, IT Consulting, Other Services, SI) is largest part of all 3 EMEA solutions opportunities: 72% of CRM, 59% of ERP, 83% of SCM HW is a small part of CRM, ERP, and SCM opportunities in EMEA: 14% of CRM, 16% of ERP, 6% of SCM SI is much larger part of EMEA SCM oppt

59、y (50.9%) than for CRM (24.2%) and ERP (16.2%) Application SW is a relatively small part of EMEA solutions opportunities (13.1% of CRM, 21% of ERP, 8.8% of SCM), but drags through many services dollarsBusiness Consulting Services Copyright IBM Corporation 200241Services is Top Opportunity for CRM, E

60、RP, SCM in APApp SW$310.4%Bus Consult$517.4%Clients$26.9%IT Consulting$13.5%MWOther Svcs$724.3%Servers$13.5%SI$931.3%Technology$11.7%2003 AP CRM Oppty By P/SHealthcare - Large Enter. ($ Millions)Source: 2H02 SMVTotal 2003 CRM oppty: $30MBusiness Consulting Services Copyright IBM Corporation 200242Se

61、rvices is Top Opportunity for CRM, ERP, SCM in APApp SW$718.9%Bus Consult$25.4%Clients$25.4%IT Consulting$12.7%MW$2Other Svcs$924.3%Servers$25.4%SI$1129.7%Technology$12.7%2003 AP ERP Oppty By P/SHealthcare - Large Enter. ($ Millions)Source: 2H02 SMVTotal 2003 ERP oppty: $37MBusiness Consulting Servi

62、ces Copyright IBM Corporation 200243Services is Top Opportunity for CRM, ERP, SCM in APApp SW$1713.6%Bus Consult$118.8%Clients$32.4%IT Consulting$64.8%MW$43.2%Other SvcsServers$129.6%SI$4636.8%Technology$108.0%2003 AP SCM Oppty by P/STotal 2003 SCM oppty: $125MHealthcare - Large Enter. ($ Millions)

63、Source: 2H02 SMVBusiness Consulting Services Copyright IBM Corporation 200244Services is Top Opportunity for CRM, ERP, SCM in AP SCM is largest solutions oppty in AP ($125M in 03), and SI is largest single segment of the AP SCM oppty (36.8%) Services (Bus. Consulting, IT Consulting, Other Services,

64、SI) are largest oppty for solutions in AP: 76.5% of CRM, 62.1% of ERP, 63.2% of SCM) HW (Clients, Servers, Technology) is relatively small segment of AP solutions oppty: 12.1% of CRM, 13.5% of ERP, 20% of SCM Applications SW is relatively small part of AP solutions oppty (10.4% of CRM, 18.9% of ERP,

65、 and 13.6% of SCM), but drags other IT dollarsBusiness Consulting Services Copyright IBM Corporation 200245Solutions Definitions: Customer Relationship Management (CRM) Customer Business Goal: -Increase customer loyalty-Increase profitability-Increase productivity-Gain competitive edge through acces

66、s in new sales, service and marketing channels Business problems/functions addressed: Improve the analysis and understanding of the customer preference & purchasing behavior across the CRM value chain including the marketing, sales and service functions aimed at providing direct personalized customer sales, service and marketing activities through multiple channels or touchpoints High level definition: CRM encompasses the business processes an enterprise performs to identify , select , acquire , dev