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Vitality and the
                      Connected Consumer
                                     Mark Scrimshire
                           Director, Internet Channel Strategy




Friday, January 29, 2010
@ekivemark                                              #HealthCamp




                                  mscrimshire@gmail.com

             http://healthca.mp
Friday, January 29, 2010
@ekivemark                                                 @ekivemark
                                                             #HealthCamp


                           The views expressed here are
                            my own and don't necessarily
                                 represent the positions,
                                    strategies or opinions
                                              of CareFirst




             http://healthca.mp
Friday, January 29, 2010
@ekivemark

                           Evolution of the Web


                1.0                 2.0 3.0
     Broadcast                   User-Generated   Sensors,
                                 Content          Filters and
                                                  Semantics



Friday, January 29, 2010
@ekivemark

        An ultra compact Web 2.0 definition....




            Web 2.0 = (Me + You )                n US




Friday, January 29, 2010
@ekivemark




                           Me
                              -nom
                                  ics
Friday, January 29, 2010
@ekivemark
                                Houston,
                           we have a problem...




                                                  nasa.gov

Friday, January 29, 2010
@ekivemark


                           “NO ONE IS HAPPY WITH THE
                             AMERICAN HEALTH-CARE
                           EXPERIENCE TODAY. IT IS AN
                              EXPENSIVE, COMPLEX
                            SYSTEM TO WHICH PEOPLE
                              RESORT ONLY WHEN A
                              PROBLEM HAS GROWN
                                 THREATENING.“
                                            BUSINESSWEEK




Friday, January 29, 2010
@ekivemark

                           Rising Health Care Costs
     $12,000
                                                                                                                                                                       18.0%


       $9,000
                                                                                                                         %GDP                                          17.0%


                                                                                                                                                                       16.0%
       $6,000




                                                                                                                                                             $11,907
                                                                                                $ 7,421
                                                                                                                                                                       15.0%


       $3,000                                                                                                                                                          14.0%


                                                                                                                                                                        13.0%
                                                                                                                    2013 2014 2015 2016
                                                                                      2007 2008 2009 2010 2011 2012
                                  1999   2000    2001    2002     2003 2004 2005 2006
                1997       1998                                                                Actual Health Expenditure as percentage of Gross Domestic Product
                   Actual Health Expenditure Per Capita
                   Projected Health Expenditure Per Capita



                                                                             ... But this is only half the story
                                     Source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group

Friday, January 29, 2010
@ekivemark                                                      South America

                 We are not getting any younger The Ch
                                              1980                                                2025
                                  Male          Age       Female                      Male          Age              Female
                                                80+                                                 80+
                                               75-79                                               75-79
                                               70-74                                               70-74


                                 $9,000
                                               65-69
                                               60-64
                                               55-59
                                                                                                   65-69
                                                                                                   60-64
                                                                                                   55-59
                                                                                                                                                      Region
                                 $7,500
                                               50-54
                                               45-49
                                                                                                   50-54
                                                                                                   45-49
                                                                                                                                                      Structu
                                               40-44                                               40-44
                                 $6,000        35-39                                               35-39
                                               30-34                                               30-34
                                                                                                                                   The term
ulation                          $4,500        25-29
                                               20-24
                                                                                                   25-29
                                                                                                   20-24
                                                                                                                                   transition




                                                                                                            Source: Kaiser
                                               15-19                                               15-19
                                 $3,000        10-14                                               10-14
                                                                                                                                   gradual p
                                                5-9                                                 5-9
                                 $1,500                                                                                            whereby
ucture:               20    15     10    5  0
                                                0-4
                                                      0     5   10   15    20      20    15 10    5
                                                                                                    0-4
                                                                                                       0       0    5   10   15 20
                                      $0                                                                                           moves fro
0 and                                 Under 5           5 - 17     18 - 24        25 - 44      45 - 64           65+               of high ra
5                                                                   Annual Spend Per Person
                                                                     North America                                                 and mort
 ions)                                                                                                                             low rates.
                                              1980                                                     2025                        is charac
                                  Male                        Female                        Male                      Female
                                                 Age
                                                 80+
                                                                                                          Age
                                                                                                          80+
                                                                                                                                   declines
                                                75-79
                                                70-74
                                                                                                         75-79
                                                                                                         70-74
                                                                                                                                   childhood
                                                65-69
                                                60-64
                                                                                                         65-69
                                                                                                         60-64
                                                                                                                                   infectious
                                                55-59                                                    55-59                     diseases




                                                                                                                              Source: Census Bureau
                                                50-54                                                    50-54
                                                45-49
                                                40-44
                                                                                                         45-49
                                                                                                         40-44
                                                                                                                                   Whole po
                                                35-39
                                                30-34
                                                                                                         35-39
                                                                                                         30-34
                                                                                                                                   begin to a
                                                25-29
                                                20-24
                                                                                                         25-29
                                                                                                         20-24
                                                                                                                                   fertility ra
                                                15-19
                                                10-14
                                                                                                         15-19
                                                                                                         10-14
                                                                                                                                   and mort
                                                 5-9
                                                 0-4
                                                                                                          5-9
                                                                                                          0-4
                                                                                                                                   all ages i
                      20    15     10    5    0       0     5   10   15    20      20    15 10    5    0       0    5   10   15 20 Successiv
                                                                            Millions                                               may even
                                                        Central America and the Caribbean                                          smaller a
             Changing age                    distribution drives up cost by2025 per person for N
                                              1980
                                                                                                            22%                    seen
                                                                                                                                   in 1980.
                                  Male           Age          Female                        Male          Age         Female
 Friday, January 29, 2010                                                                                                          declines
@ekivemark

                           Wellness Pyramid




                                          Ca
                                            re

                                                 M
                                                  an
                                                     ag
                                                       e
                                                           Pr
                                                             ev
                                                               en
                                                               t
                           Pop
                               ulat                ing
                                    ion       p end
                                             S
Friday, January 29, 2010
@ekivemark


                           Does this look like home?


                                 Is the
                                 Patient Centered Medical Home
                                                   a misnomer?




Friday, January 29, 2010
@ekivemark


                           Does this look like home?


                                 Is the
                                 Patient Centered Medical Home
                                                   a misnomer?


                                   Consumer Care
                                     Continuum

Friday, January 29, 2010
@ekivemark


                                  Does this look like home?


                                        Is the
                                        Patient Centered Medical Home
                                                          a misnomer?
                     Ambulatory




                                          Consumer Care
         Inpatient




                                              Self Managed
                                            Continuum

Friday, January 29, 2010
x
  @ekivemark
                                   What can Health 2.0 3.0
                                       do for you?
                     • Patients 50% more likely to turn up for
                           appointments they book directly
                     • 18% of online appointments avoid an ER
                           visit
                     • Adherence to medication regimes after a
                           heart attack reduces likelihood of
                           re-admittance to hospital by over 60%


Friday, January 29, 2010
@ekivemark

                    Where is Health Care?


                1.0 2.0 3.0
       Web

       Health Care

Friday, January 29, 2010
@ekivemark




   Consumers
   Have been in the dark
                           Joachim @ daysoff.wordpress.com
Friday, January 29, 2010
Laziness




    @ekivemark                  http://healthca.mp
Friday, January 29, 2010
WIFM@ekivemark             http://healthca.mp
Friday, January 29, 2010
@ekivemark
Friday, January 29, 2010
                           Competitiveness
                                        http://healthca.mp
@ekivemark




            Web 2.0 = (Me + You )            n US




                           What is this in Health Care terms?
Friday, January 29, 2010
@ekivemark




                           10 US
       Health 2.0 = (Me + MD )




Friday, January 29, 2010
@ekivemark

                           The constantly evolving web


                                  Web 3.0 =
            (( ___ ) + Me + You )
                             Sensors                n US
                            My Filters




Friday, January 29, 2010
@ekivemark

                           When Health Care and the
                             web come together

                               Health 3.0 =
      (( ___ )             Sensors          10 US
                                   + Me + MD )
                       Our Filters




Friday, January 29, 2010
@ekivemark




    Tools of
    Engagement
Friday, January 29, 2010
@ekivemark




  A growing
  ecosystem built
  around the untethered PHRs
Friday, January 29, 2010
HEALTH 2.0
                           Is participatory
                              healthcare




    @ekivemark                          http://healthca.mp
Friday, January 29, 2010
@ekivemark

                             Health 3.0 is
                           empowered vitality


                                   Clo Loop
                                   the
                                      sin
                                          g



                                   ...The Patient is the Integrator
Friday, January 29, 2010
@ekivemark




  Take advantage of
  the growing PHR ecosystem
Friday, January 29, 2010
@ekivemark




                           A.P.I.
                           Application Programming Interface




Friday, January 29, 2010
OPEN
                           INTEGRATION
                            promotes adoption




    @ekivemark                         http://healthca.mp
Friday, January 29, 2010
@ekivemark

                     Technology is evolving quickly




                                     O.D.L.


                           Observations of Daily Living

Friday, January 29, 2010
3.0
  @ekivemark



   Sensors,
   Filters and
   Semantics               PHR         ODL


                                 API
Friday, January 29, 2010
@ekivemark




                           “Use simple tools to
                             do great things”


Friday, January 29, 2010
@ekivemark
  @ekivemark




                           The future is mobile

Friday, January 29, 2010
@ekivemark

         Don’t underestimate the
         power of a simple text...




Friday, January 29, 2010
@ekivemark

         Don’t underestimate the
         power of a simple text...



                                     BP 135/83-62
                                     Feeling Good




Friday, January 29, 2010
@ekivemark

         Don’t underestimate the
         power of a simple text...



                                       Did you take
                                      BP 135/83-62
                                     your medication?
                                      Feeling Good
                                       Reply Y or N



Friday, January 29, 2010
@ekivemark

         Don’t underestimate the
         power of a simple text...



                                       Did you take
                                       Open Mobile
                                      BP 135/83-62
                                     your medication?
                                     Health Exchange
                                      Feeling Good
                                       Reply Y or N
                                         (OMHE)



Friday, January 29, 2010
@ekivemark
                           Everything is becoming
                                 connected




Friday, January 29, 2010
@ekivemark
                               Independently
                               Aging in Place

                           • Ingestible Sensors
                           • Personal Monitoring Services
                           • Online Care



Friday, January 29, 2010
3.0
  @ekivemark



   Sensors,
   Filters and
                                “D keasODL
   Semantics
                                swam 2 miles in 60 minutes”

                                “#mydiet food spaghetti pasta
                           40




                                with sauce lunch small
                           40
                            4




                                homemade #keas”
                                “D keasODL
                                120 over 80 pulse 60”
Friday, January 29, 2010
@ekivemark
   Say goodbye to the
   (relatively) simple life...



                                                               Monitors


                                   Health
                                 Applications
                                                  Health
                                                Applications
                   EMR     EHR



Friday, January 29, 2010
@ekivemark
   Expect an explosion of                         Health
                                                Applications
                                                               Twitter

   solutions                       Health
                                 Applications

                                                  Health
                                                               Facebook
                                                Applications

                                   Health
                                 Applications

                                                  Health
                                                               Monitors
                                                Applications


                                   Health
                                 Applications
                                                  Health       Mobile
                                                Applications   Devices
                   EMR     EHR



Friday, January 29, 2010
@ekivemark
  Untethered PHRs can                             Health
                                                Applications
                                                               Twitter

  be a data conduit                Health
                                 Applications

                                                  Health
                                                               Facebook
                                                Applications

                                   Health
                                 Applications

                                                  Health
                                                               Monitors
                                                Applications


                                   Health
                                 Applications
                                                  Health       Mobile
                                                Applications   Devices
                   EMR     EHR



Friday, January 29, 2010
@ekivemark
                           Patients are already doing it
                                  for themselves




Friday, January 29, 2010
@ekivemark
                                  Tap in to Health
                                  Self Management
                  Ambulatory
      Inpatient




                                           Self Managed




                                           Mobile         ODLs
                                           Devices
                               Reminders

           EHR                                 PHR



Friday, January 29, 2010
A light at •   Embrace the PHR
                    the end of      •   Engage the Patient
               the tunnel
                                   •     Use their measurements


Friday, January 29, 2010
                                   •       Bi-directional data flows estaesmivida.net/
Mark Scrimshire
                             Director, Internet Channel Strategy




                          e: mscrimshire@gmail.com
               o: +1.410.998.4857          t/a/s: @ekivemark



             http://healthca.mp
Friday, January 29, 2010

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Health30 - Vitality and the connected consumer

  • 1. Vitality and the Connected Consumer Mark Scrimshire Director, Internet Channel Strategy Friday, January 29, 2010
  • 2. @ekivemark #HealthCamp mscrimshire@gmail.com http://healthca.mp Friday, January 29, 2010
  • 3. @ekivemark @ekivemark #HealthCamp The views expressed here are my own and don't necessarily represent the positions, strategies or opinions of CareFirst http://healthca.mp Friday, January 29, 2010
  • 4. @ekivemark Evolution of the Web 1.0 2.0 3.0 Broadcast User-Generated Sensors, Content Filters and Semantics Friday, January 29, 2010
  • 5. @ekivemark An ultra compact Web 2.0 definition.... Web 2.0 = (Me + You ) n US Friday, January 29, 2010
  • 6. @ekivemark Me -nom ics Friday, January 29, 2010
  • 7. @ekivemark Houston, we have a problem... nasa.gov Friday, January 29, 2010
  • 8. @ekivemark “NO ONE IS HAPPY WITH THE AMERICAN HEALTH-CARE EXPERIENCE TODAY. IT IS AN EXPENSIVE, COMPLEX SYSTEM TO WHICH PEOPLE RESORT ONLY WHEN A PROBLEM HAS GROWN THREATENING.“ BUSINESSWEEK Friday, January 29, 2010
  • 9. @ekivemark Rising Health Care Costs $12,000 18.0% $9,000 %GDP 17.0% 16.0% $6,000 $11,907 $ 7,421 15.0% $3,000 14.0% 13.0% 2013 2014 2015 2016 2007 2008 2009 2010 2011 2012 1999 2000 2001 2002 2003 2004 2005 2006 1997 1998 Actual Health Expenditure as percentage of Gross Domestic Product Actual Health Expenditure Per Capita Projected Health Expenditure Per Capita ... But this is only half the story Source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group Friday, January 29, 2010
  • 10. @ekivemark South America We are not getting any younger The Ch 1980 2025 Male Age Female Male Age Female 80+ 80+ 75-79 75-79 70-74 70-74 $9,000 65-69 60-64 55-59 65-69 60-64 55-59 Region $7,500 50-54 45-49 50-54 45-49 Structu 40-44 40-44 $6,000 35-39 35-39 30-34 30-34 The term ulation $4,500 25-29 20-24 25-29 20-24 transition Source: Kaiser 15-19 15-19 $3,000 10-14 10-14 gradual p 5-9 5-9 $1,500 whereby ucture: 20 15 10 5 0 0-4 0 5 10 15 20 20 15 10 5 0-4 0 0 5 10 15 20 $0 moves fro 0 and Under 5 5 - 17 18 - 24 25 - 44 45 - 64 65+ of high ra 5 Annual Spend Per Person North America and mort ions) low rates. 1980 2025 is charac Male Female Male Female Age 80+ Age 80+ declines 75-79 70-74 75-79 70-74 childhood 65-69 60-64 65-69 60-64 infectious 55-59 55-59 diseases Source: Census Bureau 50-54 50-54 45-49 40-44 45-49 40-44 Whole po 35-39 30-34 35-39 30-34 begin to a 25-29 20-24 25-29 20-24 fertility ra 15-19 10-14 15-19 10-14 and mort 5-9 0-4 5-9 0-4 all ages i 20 15 10 5 0 0 5 10 15 20 20 15 10 5 0 0 5 10 15 20 Successiv Millions may even Central America and the Caribbean smaller a Changing age distribution drives up cost by2025 per person for N 1980 22% seen in 1980. Male Age Female Male Age Female Friday, January 29, 2010 declines
  • 11. @ekivemark Wellness Pyramid Ca re M an ag e Pr ev en t Pop ulat ing ion p end S Friday, January 29, 2010
  • 12. @ekivemark Does this look like home? Is the Patient Centered Medical Home a misnomer? Friday, January 29, 2010
  • 13. @ekivemark Does this look like home? Is the Patient Centered Medical Home a misnomer? Consumer Care Continuum Friday, January 29, 2010
  • 14. @ekivemark Does this look like home? Is the Patient Centered Medical Home a misnomer? Ambulatory Consumer Care Inpatient Self Managed Continuum Friday, January 29, 2010
  • 15. x @ekivemark What can Health 2.0 3.0 do for you? • Patients 50% more likely to turn up for appointments they book directly • 18% of online appointments avoid an ER visit • Adherence to medication regimes after a heart attack reduces likelihood of re-admittance to hospital by over 60% Friday, January 29, 2010
  • 16. @ekivemark Where is Health Care? 1.0 2.0 3.0 Web Health Care Friday, January 29, 2010
  • 17. @ekivemark Consumers Have been in the dark Joachim @ daysoff.wordpress.com Friday, January 29, 2010
  • 18. Laziness @ekivemark http://healthca.mp Friday, January 29, 2010
  • 19. WIFM@ekivemark http://healthca.mp Friday, January 29, 2010
  • 20. @ekivemark Friday, January 29, 2010 Competitiveness http://healthca.mp
  • 21. @ekivemark Web 2.0 = (Me + You ) n US What is this in Health Care terms? Friday, January 29, 2010
  • 22. @ekivemark 10 US Health 2.0 = (Me + MD ) Friday, January 29, 2010
  • 23. @ekivemark The constantly evolving web Web 3.0 = (( ___ ) + Me + You ) Sensors n US My Filters Friday, January 29, 2010
  • 24. @ekivemark When Health Care and the web come together Health 3.0 = (( ___ ) Sensors 10 US + Me + MD ) Our Filters Friday, January 29, 2010
  • 25. @ekivemark Tools of Engagement Friday, January 29, 2010
  • 26. @ekivemark A growing ecosystem built around the untethered PHRs Friday, January 29, 2010
  • 27. HEALTH 2.0 Is participatory healthcare @ekivemark http://healthca.mp Friday, January 29, 2010
  • 28. @ekivemark Health 3.0 is empowered vitality Clo Loop the sin g ...The Patient is the Integrator Friday, January 29, 2010
  • 29. @ekivemark Take advantage of the growing PHR ecosystem Friday, January 29, 2010
  • 30. @ekivemark A.P.I. Application Programming Interface Friday, January 29, 2010
  • 31. OPEN INTEGRATION promotes adoption @ekivemark http://healthca.mp Friday, January 29, 2010
  • 32. @ekivemark Technology is evolving quickly O.D.L. Observations of Daily Living Friday, January 29, 2010
  • 33. 3.0 @ekivemark Sensors, Filters and Semantics PHR ODL API Friday, January 29, 2010
  • 34. @ekivemark “Use simple tools to do great things” Friday, January 29, 2010
  • 35. @ekivemark @ekivemark The future is mobile Friday, January 29, 2010
  • 36. @ekivemark Don’t underestimate the power of a simple text... Friday, January 29, 2010
  • 37. @ekivemark Don’t underestimate the power of a simple text... BP 135/83-62 Feeling Good Friday, January 29, 2010
  • 38. @ekivemark Don’t underestimate the power of a simple text... Did you take BP 135/83-62 your medication? Feeling Good Reply Y or N Friday, January 29, 2010
  • 39. @ekivemark Don’t underestimate the power of a simple text... Did you take Open Mobile BP 135/83-62 your medication? Health Exchange Feeling Good Reply Y or N (OMHE) Friday, January 29, 2010
  • 40. @ekivemark Everything is becoming connected Friday, January 29, 2010
  • 41. @ekivemark Independently Aging in Place • Ingestible Sensors • Personal Monitoring Services • Online Care Friday, January 29, 2010
  • 42. 3.0 @ekivemark Sensors, Filters and “D keasODL Semantics swam 2 miles in 60 minutes” “#mydiet food spaghetti pasta 40 with sauce lunch small 40 4 homemade #keas” “D keasODL 120 over 80 pulse 60” Friday, January 29, 2010
  • 43. @ekivemark Say goodbye to the (relatively) simple life... Monitors Health Applications Health Applications EMR EHR Friday, January 29, 2010
  • 44. @ekivemark Expect an explosion of Health Applications Twitter solutions Health Applications Health Facebook Applications Health Applications Health Monitors Applications Health Applications Health Mobile Applications Devices EMR EHR Friday, January 29, 2010
  • 45. @ekivemark Untethered PHRs can Health Applications Twitter be a data conduit Health Applications Health Facebook Applications Health Applications Health Monitors Applications Health Applications Health Mobile Applications Devices EMR EHR Friday, January 29, 2010
  • 46. @ekivemark Patients are already doing it for themselves Friday, January 29, 2010
  • 47. @ekivemark Tap in to Health Self Management Ambulatory Inpatient Self Managed Mobile ODLs Devices Reminders EHR PHR Friday, January 29, 2010
  • 48. A light at • Embrace the PHR the end of • Engage the Patient the tunnel • Use their measurements Friday, January 29, 2010 • Bi-directional data flows estaesmivida.net/
  • 49. Mark Scrimshire Director, Internet Channel Strategy e: mscrimshire@gmail.com o: +1.410.998.4857 t/a/s: @ekivemark http://healthca.mp Friday, January 29, 2010

Editor's Notes

  1. 2:00 How to Achieve Vitality for the Connected Healthcare Consumer through Health 3.0 As the baby boomer generation is beginning to retire and the costs of healthcare continue to rise, how can technology and networks evolve to help us manage our life long health and wellness? This session focuses on how health technology lowers the cost of healthcare by the developments of home tools and by analyzing the abundant amounts data collected from these tools. As technology becomes more advanced, plans have the opportunity to take the data collected from the tools and apply them to identify at risk members, monitor members’ health, and eventually enable automatic analysis of members’ by computers. This session highlights: The importance of electronic health records and how they will be essential to the future of healthcare How to make sense of and filter the growing amount of data collected from electronic health records to better monitor members Using the data collected to create even better tools that enable members’ vitality Mark Scrimshire Director, Internet Channel Strategy CareFirst BlueCross BlueShield
  2. 2:00 How to Achieve Vitality for the Connected Healthcare Consumer through Health 3.0 As the baby boomer generation is beginning to retire and the costs of healthcare continue to rise, how can technology and networks evolve to help us manage our life long health and wellness? This session focuses on how health technology lowers the cost of healthcare by the developments of home tools and by analyzing the abundant amounts data collected from these tools. As technology becomes more advanced, plans have the opportunity to take the data collected from the tools and apply them to identify at risk members, monitor members’ health, and eventually enable automatic analysis of members’ by computers. This session highlights: The importance of electronic health records and how they will be essential to the future of healthcare How to make sense of and filter the growing amount of data collected from electronic health records to better monitor members Using the data collected to create even better tools that enable members’ vitality Mark Scrimshire Director, Internet Channel Strategy CareFirst BlueCross BlueShield
  3. 2:00 How to Achieve Vitality for the Connected Healthcare Consumer through Health 3.0 As the baby boomer generation is beginning to retire and the costs of healthcare continue to rise, how can technology and networks evolve to help us manage our life long health and wellness? This session focuses on how health technology lowers the cost of healthcare by the developments of home tools and by analyzing the abundant amounts data collected from these tools. As technology becomes more advanced, plans have the opportunity to take the data collected from the tools and apply them to identify at risk members, monitor members’ health, and eventually enable automatic analysis of members’ by computers. This session highlights: The importance of electronic health records and how they will be essential to the future of healthcare How to make sense of and filter the growing amount of data collected from electronic health records to better monitor members Using the data collected to create even better tools that enable members’ vitality Mark Scrimshire Director, Internet Channel Strategy CareFirst BlueCross BlueShield